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LON STEVEN RUPPEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
4845 24TH AVE, FORT GRATIOT, MI 48059-3407
(810) 385-7747
(810) 385-4679
Mailing address
5880 S BOB WHITE DRIVE, KIMBALL, MI 48074
(810) 941-8286

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302026224
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5302026224
PHARMACIST LICENSE
MI
Enumeration date
10/14/2016
Last updated
10/14/2016
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