Individual
MRS. KELLY SUE NORDSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
325 E H ST, IRON MOUNTAIN, MI 49801-4760
(800) 215-8262
(906) 779-3141
Mailing address
3078 HWY M35, BARK RIVER, MI 49807
(906) 786-3824
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302027309
MI
Other
Enumeration date
09/07/2006
Last updated
07/08/2007
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