Individual
DOUGLAS ROLAND CORY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12743 STRAIT RD, HANOVER, MI 49241-9742
(517) 392-5269
Mailing address
12743 STRAIT RD, HANOVER, MI 49241-9742
(517) 392-5269
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
5302042510
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1209579
NATIONAL ASSOCIATION OF BOARDS OF PHARMACY (NABP) NUMBER
MI
01
—
5302042510
PHARMACY INTERN LICENSE
MI
Enumeration date
04/24/2017
Last updated
04/24/2017
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