Individual
DIANE JILL SHAWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPHT
Contact information
Practice address
1411 S. MAIN ST., EATON RAPIDS, MI 48827
(517) 663-8331
(517) 663-0010
Mailing address
407 E ELIZABETH ST, EATON RAPIDS, MI 48827
(517) 663-6472
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
210118142753913
MI
Other
Enumeration date
10/13/2006
Last updated
07/08/2007
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