Individual
JULIE BLUST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
306 W LAKE ST, TAWAS CITY, MI 48763-8308
(989) 362-3311
Mailing address
273 BISCHOFF RD, TAWAS CITY, MI 48763-9224
(989) 362-8106
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302028582
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5302028582
PHARMACIST LICENSE NUMBER
MI
Enumeration date
10/17/2006
Last updated
07/08/2007
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