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General NPI Number Information
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NPI Number | 1043432099
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Entity Type | Individual
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Provider Name | MARY ANN SPENCER CPHT
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Gender | Female
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2825 LIVERNOIS RD
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City | TROY
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State | MI
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Zip | 48083-1214
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Country | US
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Telephone | 248-528-2248
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Fax | 248-689-8002
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Provider Business Mailing Address
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Address Line | 846 LION STREET
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City | ROCHESTER HILLS
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State | MI
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Zip | 48307
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Country | US
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Telephone | 248-528-2248
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Fax | 248-689-8002
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 100105321728958
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License Number State | MI
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