Individual
MS. AMIE NICOLE BOULANGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
12850 ADAMS RD, GRANGER, IN 46530-7183
(574) 807-8234
Mailing address
65875 TURPIN RD, CASSOPOLIS, MI 49031-9630
(574) 876-7177
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26019763A
IN
Other
Enumeration date
12/21/2020
Last updated
12/22/2020
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