Healthcare Provider Details

I. General information

NPI: 1073159141
Provider Name (Legal Business Name): HALEIGH MARSH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2019
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1315 E M 21
OWOSSO MI
48867-9039
US

IV. Provider business mailing address

1315 E M 21
OWOSSO MI
48867-9039
US

V. Phone/Fax

Practice location:
  • Phone: 989-729-0275
  • Fax:
Mailing address:
  • Phone: 989-729-0275
  • Fax: 989-729-0635

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302042599
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: