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TIJO THOMAS MANTHURUTHIL PHARMD
>> Pharmacist >> Pharmacy Service ProvidersRegistrant NPI Number: 1518579853
Individual Registrant: TIJO THOMAS MANTHURUTHIL PHARMD
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
337 N STATE RD OTISVILLE, MI 48463-9486 US
Tel: 810-631-4551 Fax: --
Tel: 810-631-4551 Fax: --
Contact information for business:
337 N STATE RD OTISVILLE, MI 48463-9486 US
Tel: -- Fax: --
Tel: -- Fax: --
Registration Information:
NPI: 1518579853
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 183500000X | Pharmacy Service Providers Pharmacist | MI | 5302412466 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
