Individual
LONG P TO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1191 SOUTH BLVD E, ROCHESTER HILLS, MI 48307-5453
(586) 216-0017
Mailing address
42280 LOCKLIN DR, STERLING HEIGHTS, MI 48314-2822
(586) 216-0017
Taxonomy
Speciality
Code
Description
License number
State
1835P2201X
Ambulatory Care Pharmacist
Primary
5302037362
MI
Other
Enumeration date
04/01/2024
Last updated
04/01/2024
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