Individual
BENJAMIN JACOB DEMONGEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM D
Contact information
Practice address
1105 SIXTH ST, TRAVERSE CITY, MI 49684-2345
(231) 935-6598
Mailing address
3883 CENTRAL PARK DR, GRAWN, MI 49637-9721
(231) 409-0168
Taxonomy
Speciality
Code
Description
License number
State
1835N1003X
Nutrition Support Pharmacist
Primary
5302033882
MI
Other
Enumeration date
08/01/2008
Last updated
08/01/2008
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