Individual
ROXANNE MICHELLE DELISLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPHT, LPHT
Contact information
Practice address
337 N STATE RD, OTISVILLE, MI 48463-9486
(810) 631-4551
Mailing address
134 SUMMIT DR, LAPEER, MI 48446-1400
(810) 610-9784
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
5303032567
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1435854
NABP
MI
01
—
30111877
PTCB
MI
01
—
5303032567
LARA
MI
Enumeration date
02/17/2023
Last updated
02/17/2023
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