Individual
MR. GREG BAISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
34722 PEMBROKE AVE, LIVONIA, MI 48152-4052
(313) 632-4962
Mailing address
34722 PEMBROKE AVE, LIVONIA, MI 48152-4052
(313) 632-4962
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302023505
MI
Other
Enumeration date
06/02/2011
Last updated
06/02/2011
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