| NPI | 1083770978 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNY RAY WALKUP Owner 248-446-2643 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: MI 5301007610) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2013-04-19 |