Individual
GRACE SESI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4901 HAGGERTY RD, WEST BLOOMFIELD, MI 48323-3903
(313) 516-6915
Mailing address
4901 HAGGERTY RD, WEST BLOOMFIELD, MI 48323-3903
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302035069
MI
Other
Enumeration date
01/24/2020
Last updated
01/24/2020
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