Individual
MARIE L BRACKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
355 54TH ST SW, WYOMING, MI 49548-5614
(616) 552-6226
Mailing address
4334 HAYES ST, COOPERSVILLE, MI 49404-9662
(616) 890-5974
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302025984
MI
Other
Enumeration date
11/05/2020
Last updated
11/05/2020
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