Individual
HENRY R LOOTENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
4190 24TH AVE, FORT GRATIOT, MI 48059-3882
(810) 989-7480
Mailing address
6439 PECK RD, LEXINGTON, MI 48450-9333
(810) 359-7009
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302027454
MI
Other
Enumeration date
03/23/2007
Last updated
07/08/2007
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