Individual provider · NPI-1

Addison Grace Mattson

Pharmacy Technician · Lansing, MI

NPI number1679147599
StatusActive
Last updated in NPPESMay 15, 2021

Details

NPI
1679147599
Entity type
Individual (NPI-1)
Name
Addison Grace Mattson
Sex
Female
Sole proprietor
Yes
Enumeration date
May 15, 2021
Certification date
May 15, 2021
Last updated
May 15, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
183700000X Pharmacy Technician5303036282MIYes

Practice location

409 N Marketplace Blvd
Lansing, MI 48917-7732

Phone 517-622-1451

Mailing address

409 N Marketplace Blvd
Lansing, MI 48917-7732

Phone 517-622-1451

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