Individual
HOLLY BOGAUDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1112 S STEPHENSON AVE, IRON MOUNTAIN, MI 49801-4038
(906) 774-3654
(906) 774-5502
Mailing address
PO BOX 189, IRON MOUNTAIN, MI 49801-0189
(906) 774-3654
(906) 774-5502
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302028704
MI
Other
Enumeration date
04/25/2017
Last updated
04/25/2017
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