Individual
ASHLEY JEANETTE BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8089 LAPEER RD, DAVISON, MI 48423-2529
(810) 658-5410
Mailing address
8089 LAPEER RD, DAVISON, MI 48423-2529
(810) 658-5410
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302415242
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5315243585
CONTROLLED SUBSTANCE LICENSE
MI
Enumeration date
08/10/2023
Last updated
08/10/2023
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