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General NPI Number Information
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NPI Number | 1578687562
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Entity Type | Individual
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Provider Name | DR. LAURA M HORAN
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Gender | Female
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Dates
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Enumeration Date | 03/17/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 821 E APPLE AVE
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City | MUSKEGON
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State | MI
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Zip | 49442-3737
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Country | US
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Telephone | 231-777-4969
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Fax |
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Provider Business Mailing Address
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Address Line | 2136 HUDSON ST
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City | MUSKEGON
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State | MI
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Zip | 49441-3028
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Country | US
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Telephone | 231-578-8108
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 5302033263
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License Number State | MI
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