Provider Demographics
NPI:1710273461
Name:GIFFIN, ALLISON RENEE (PHARMD)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:RENEE
Last Name:GIFFIN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47330 MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48188-2582
Mailing Address - Country:US
Mailing Address - Phone:734-714-2013
Mailing Address - Fax:734-714-2115
Practice Address - Street 1:47330 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48188-2582
Practice Address - Country:US
Practice Address - Phone:734-714-2013
Practice Address - Fax:734-714-2115
Is Sole Proprietor?:No
Enumeration Date:2011-06-21
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302033716183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist