Individual
CARLY ANASTACIA GREENHOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
08337 M 140 STE 2, SOUTH HAVEN, MI 49090-1990
(269) 637-3222
Mailing address
12713 3 MILE RD NE, LOWELL, MI 49331-9456
(616) 490-2722
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302047222
MI
Other
Enumeration date
10/23/2018
Last updated
10/23/2018
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