Individual
KSHAMA S JAYASURIYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.PH
Contact information
Practice address
39450 W 12 MILE RD, NOVI, MI 48377-3600
(248) 344-0705
(248) 344-0735
Mailing address
39450 W 12 MILE RD, NOVI, MI 48377-3600
(248) 344-0705
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302036004
MI
Other
Enumeration date
11/01/2006
Last updated
03/02/2011
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