Individual
MALLORY BREISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5150 COOLIDGE HWY, ROYAL OAK, MI 48073-1001
(248) 280-5010
Mailing address
5150 COOLIDGE HWY, ROYAL OAK, MI 48073-1001
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302041583
MI
Other
Enumeration date
08/18/2016
Last updated
08/18/2016
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