Provider Demographics
NPI:1225312770
Name:CLINE, JUDITH J (RPH)
Entity Type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:J
Last Name:CLINE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10350 S CLARE AVE
Mailing Address - Street 2:
Mailing Address - City:CLARE
Mailing Address - State:MI
Mailing Address - Zip Code:48617-9733
Mailing Address - Country:US
Mailing Address - Phone:989-386-9905
Mailing Address - Fax:989-386-5484
Practice Address - Street 1:10350 S CLARE AVE
Practice Address - Street 2:
Practice Address - City:CLARE
Practice Address - State:MI
Practice Address - Zip Code:48617-9733
Practice Address - Country:US
Practice Address - Phone:989-386-9905
Practice Address - Fax:989-386-5484
Is Sole Proprietor?:No
Enumeration Date:2011-10-03
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302024637183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist