Individual
JESSICA PRUSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2829 DIVISION AVE S, WYOMING, MI 49548-1152
(616) 248-9030
Mailing address
2829 DIVISION AVE S, WYOMING, MI 49548-1152
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302039911
MI
Other
Enumeration date
02/17/2015
Last updated
02/17/2015
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