Michael C Boushon, R.PH.

NPI #1376598946 in Lac Du Flambeau, Wisconsin

Provider Information

NPI Number: 1376598946
Entity Type: Individual
Name: Michael C Boushon, R.PH.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pharmacist
Credential: R.PH.
Enumeration Date: May 23, 2006
Last Updated: Aug 21, 2008

Practice Location

Address: 450 OLD ABE RD
City: Lac Du Flambeau
State: Wisconsin
ZIP Code: 54538-9682
Phone: (715) 588-4267

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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