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1861970204
MARK MITTLESTAT
LIVONIA, MI
NPI
1861970204
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
183500000X Pharmacist
(Licence: MI 5302022896)
Enumeration Date
2018-07-29
Last Update Date
2018-07-29
Business Address
MARK MITTLESTAT
31320 FIVE MILE RD
LIVONIA, MI 48154-3680
Phone number: 734-427-3430
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Mailing Address
MARK MITTLESTAT
31320 FIVE MILE RD
LIVONIA, MI 48154-3680
Phone number: 734-427-3430
Copy
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