Individual
MR. EUGENE LEO NIEDZWIECKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1290 W MAIN ST, GAYLORD, MI 49735-8340
(989) 732-0578
Mailing address
1290 W MAIN ST, GAYLORD, MI 49735-8340
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302020450
MI
Other
Enumeration date
10/20/2011
Last updated
10/20/2011
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