Provider Demographics
NPI:1740715226
Name:COBB, ALLISON (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:
Last Name:COBB
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MISS
Other - First Name:ALLISON
Other - Middle Name:
Other - Last Name:ALLARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17717 174TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPRING LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:49456-8879
Mailing Address - Country:US
Mailing Address - Phone:616-842-4706
Mailing Address - Fax:616-842-4716
Practice Address - Street 1:17717 174TH AVE
Practice Address - Street 2:
Practice Address - City:SPRING LAKE
Practice Address - State:MI
Practice Address - Zip Code:49456-8879
Practice Address - Country:US
Practice Address - Phone:616-842-4706
Practice Address - Fax:616-842-4716
Is Sole Proprietor?:No
Enumeration Date:2017-04-21
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302036181183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist