Individual
MRS. JESSICA DEANER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
1221 PINE GROVE AVE, PORT HURON, MI 48060-3511
(810) 985-2644
Mailing address
8743 LAMBS RD, WALES, MI 48027-3101
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302030575
MI
Other
Enumeration date
09/16/2011
Last updated
09/16/2011
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