Individual
MR. DWAYNE GLENN BLOEMERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1125 WASHINGTON, GRAND HAVEN, MI 49417
(616) 842-4360
(616) 842-9590
Mailing address
13496 REDBIRD LN, GRAND HAVEN, MI 49417
(616) 846-3465
(616) 842-9590
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
53602020782
MI
Other
Enumeration date
11/06/2006
Last updated
07/08/2007
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