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1285177493
OPAL M BACON
DETROIT, MI
NPI
1285177493
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1835P1300X Pharmacist, Psychiatric
(Licence: MI 5302044753)
Enumeration Date
2016-11-21
Last Update Date
2016-11-21
Business Address
-- OPAL M BACON PharmD
1 FORD PLACE, 1C OUTPATIENT PSYCHIATRY
DETROIT, MI 48202
Phone number: 313-556-7882
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Mailing Address
-- OPAL M BACON PharmD
2065 ANITA AVE
GROSSE POINTE WOODS, MI 48236-1427
Phone number:
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