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Individual

DAN YAW GORDON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARMACIST

Contact information

Practice address
812 E SAGINAW HWY, GRAND LEDGE, MI 48837-8410
(517) 627-1240
Mailing address
1115 RUNAWAY BAY DR APT 2D, LANSING, MI 48917-8729
(682) 240-1660

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
21294021001
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
21294021001
PHARMACIST
MI
Enumeration date
09/22/2022
Last updated
09/22/2022
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