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NPI 1770643660

NPI 1770643660 : KENNETH C BRIGGS R.PH. : JACKSON, MI

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General NPI Number Information
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    NPI Number           |    1770643660
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    Entity Type          |    Individual 
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    Provider Name        |    KENNETH C BRIGGS R.PH.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    12/11/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    900 E GANSON ST 
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    City                 |    JACKSON
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    State                |    MI
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    Zip                  |    49201-1700
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    Country              |    US
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    Telephone            |    517-787-3194
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    Fax                  |    517-787-8005
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Provider Business Mailing Address
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    Address Line         |    4021 LOVE DR 
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    City                 |    JACKSON
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    State                |    MI
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    Zip                  |    49201-8427
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    Country              |    US
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    Telephone            |    517-764-5424
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    Fax                  |    517-764-5706
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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       |    53020119527
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    License Number State |    MI
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