Individual
JESSICA MALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
6223 W JEFFERSON AVE, DETROIT, MI 48209
(906) 346-5543
Mailing address
6331 E JEFFERSON AVE, DETROIT, MI 48207-4317
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302037247
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1689943359
NPI
MI
Enumeration date
12/23/2011
Last updated
02/17/2013
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