Provider Demographics
NPI:1003923806
Name:TWISS, DAVID E (RPH)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:E
Last Name:TWISS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12506 PARK HILL LN
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:MI
Mailing Address - Zip Code:49068-8708
Mailing Address - Country:US
Mailing Address - Phone:269-781-3808
Mailing Address - Fax:
Practice Address - Street 1:1411 S MAIN ST
Practice Address - Street 2:
Practice Address - City:EATON RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:48827-1953
Practice Address - Country:US
Practice Address - Phone:517-663-8331
Practice Address - Fax:517-663-0010
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302024853183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist