Individual
CATHERINE FORMALEJO PADOGDOG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2051 RIDGECREST RD SE APT 7, GRAND RAPIDS, MI 49546-4321
(616) 322-4036
Mailing address
1106 BURTON ST SW, WYOMING, MI 49509-1435
(616) 245-2463
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302042922
MI
Other
Enumeration date
01/12/2019
Last updated
01/12/2019
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