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General NPI Number Information
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NPI Number | 1558420315
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Entity Type | Individual
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Provider Name | AMY MARIE CONNER CPHT
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Gender | Female
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Dates
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Enumeration Date | 12/07/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 22505 ALLEN RD
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City | WOODHAVEN
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State | MI
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Zip | 48183-2237
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Country | US
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Telephone | 734-676-7474
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Fax | 734-676-7075
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Provider Business Mailing Address
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Address Line | 1217 LINDBERGH ST
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City | WYANDOTTE
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State | MI
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Zip | 48192-3410
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Country | US
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Telephone | 734-282-4360
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Fax |
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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 | 3301-0105-1150-077
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License Number State | MI
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