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1245643014
MAIN MAITAH
DETROIT, MI
NPI
1245643014
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
183500000X Pharmacist
(Licence: MI 5302037681)
Enumeration Date
2014-06-09
Last Update Date
2014-06-09
Business Address
-- MAIN MAITAH RPH
19160 GREENFIELD RD
DETROIT, MI 48235-2001
Phone number: 313-862-2603
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Mailing Address
-- MAIN MAITAH RPH
19160 GREENFIELD RD
DETROIT, MI 48235-2001
Phone number:
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