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General NPI Number Information
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NPI Number | 1982985206
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Entity Type | Individual
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Provider Name | MELISSA PRYBOR PHARMD,BSPS,MBA,RPH
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Gender | Female
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Dates
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Enumeration Date | 08/31/2011
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Last Update Date | 08/31/2011
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Provider Practice Location Address
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Address Line | 100 CABELAS BLVD E WALGREENS #12288
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City | DUNDEE
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State | MI
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Zip | 48131-9693
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Country | US
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Telephone | 734-529-5395
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Fax |
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Provider Business Mailing Address
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Address Line | 2132 STIRRUP LN APT A102
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City | TOLEDO
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State | OH
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Zip | 43613-5610
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Country | US
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Telephone |
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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 | 03230611
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 5302040372
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License Number State | MI
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