Individual
BETHANY LUANNE HISSONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
720 S MITCHELL ST, CADILLAC, MI 49601-2512
(231) 775-3243
Mailing address
1358 N US HIGHWAY 131, MANTON, MI 49663-9182
(231) 824-9020
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302025540
MI
Other
Enumeration date
04/24/2007
Last updated
07/08/2007
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