Provider Demographics
NPI:1588950083
Name:BRATTAIN, ALLISON (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:
Last Name:BRATTAIN
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 1:28800 DEQUINDRE RD
Mailing Address - Street 2:T-2544
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48092-2466
Mailing Address - Country:US
Mailing Address - Phone:586-353-1151
Mailing Address - Fax:586-353-1161
Practice Address - Street 1:28800 DEQUINDRE RD
Practice Address - Street 2:T-2544
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48092-2466
Practice Address - Country:US
Practice Address - Phone:586-353-1151
Practice Address - Fax:586-353-1161
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-22
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302036672183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist