| NPI | 1104254259 |
|---|---|
| Doing Business As | MI DOCTOR #12 |
| Entity Type | Organization |
| Authorized Contact | SUSAN ELAINE BARTLEMAY Manager, Pharmacy Operations 972-207-4922 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0002X Pharmacy, Clinic Pharmacy |
| Enumeration Date | 2013-10-29 |
| Last Update Date | 2013-10-29 |