Provider Demographics
NPI:1598852485
Name:MARSAC, DEBORAH L (RPH)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:L
Last Name:MARSAC
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 1:8380 HOLCOMB RD
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48348-4316
Mailing Address - Country:US
Mailing Address - Phone:248-625-6363
Mailing Address - Fax:
Practice Address - Street 1:12731 S SAGINAW ST
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-1830
Practice Address - Country:US
Practice Address - Phone:810-953-9158
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302025349183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist