Individual
MR. ADDISON JAMES BALZER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMACY INTERN
Contact information
Practice address
100 CHERRY ST SE, GRAND RAPIDS, MI 49503-4526
(616) 965-8390
Mailing address
616 4TH ST NW APT 2E, GRAND RAPIDS, MI 49504-5164
(989) 928-5556
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5351012502
MI
Other
Enumeration date
01/04/2022
Last updated
01/05/2022
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