Provider First Line Business Practice Location Address:
530 2ND ST
Provider Second Line Business Practice Location Address:
MICKLESEN DRUG INC
Provider Business Practice Location Address City Name:
HUDSON
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
54016
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
715-386-3344
Provider Business Practice Location Address Fax Number:
715-386-5198
Provider Enumeration Date:
09/06/2007