Registry details
Type
Individual
Primary specialty
Pharmacist
Enumerated
Aug 10, 2006
License(s)
5302029217 (MI)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 30112 HIGH VALLEY RD | Farmington Hills, MI 48331-2167 | 248-592-0661 |
| LOCATION | 4646 JOHN R ST | Detroit, MI 48201-1916 | 313-576-3233 |
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