Individual
MAMATHA ROUTHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20730 PONTIAC TRL, SOUTH LYON, MI 48178-9486
(248) 486-9182
Mailing address
20730 PONTIAC TRL, SOUTH LYON, MI 48178-9486
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302035244
MI
Other
Enumeration date
11/29/2019
Last updated
11/29/2019
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