Individual
RENEE MARIE JORGENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPHT
Contact information
Practice address
8744 FERRY ST, MONTAGUE, MI 49437-1391
(231) 893-8255
Mailing address
8744 FERRY ST, MONTAGUE, MI 49437-1391
(231) 893-8255
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
0501-0110-8473-164
MI
Other
Enumeration date
09/15/2006
Last updated
07/08/2007
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