Individual
MR. CLYDE KENNETH GODIN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4646 JOHN R ST, DETROIT, MI 48201-1916
(313) 576-3386
Mailing address
47000 GLENHURST DR, CANTON, MI 48187-4708
(734) 451-0350
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302022397
MI
Other
Enumeration date
08/04/2006
Last updated
07/08/2007
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