Individual
COREY EDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
29451 PLYMOUTH RD, LIVONIA, MI 48150-2112
(734) 793-0638
Mailing address
820 FULLER ST, APT. 205, ANN ARBOR, MI 48104-1259
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302039031
MI
Other
Enumeration date
06/25/2012
Last updated
06/25/2012
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