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Individual

MS. DEBRA K WONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RPH

Contact information

Practice address
27300 WIXOM RD, NOVI, MI 48374
(248) 349-6043
Mailing address
27300 WIXOM RD, NOVI, MI 48374
(248) 349-6043
(248) 349-6121

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5315027658
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2368404
MI
Enumeration date
12/12/2006
Last updated
07/08/2007
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