Individual
MISS MELONEZE RENEE BLACKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
22777 W 11 MILE RD, SOUTHFIELD, MI 48033-2152
(248) 358-0727
(248) 358-9394
Mailing address
22777 W 11 MILE RD, SOUTHFIELD, MI 48033-2152
(248) 358-0727
(248) 358-9394
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
300101041151852
MI
Other
Enumeration date
04/25/2007
Last updated
09/23/2010
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