Provider Demographics
NPI:1588955629
Name:LENTZ, JULIANNE MARIE (RPH)
Entity type:Individual
Prefix:
First Name:JULIANNE
Middle Name:MARIE
Last Name:LENTZ
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 1:3939 S LAPEER RD
Mailing Address - Street 2:
Mailing Address - City:METAMORA
Mailing Address - State:MI
Mailing Address - Zip Code:48455-8950
Mailing Address - Country:US
Mailing Address - Phone:810-678-2331
Mailing Address - Fax:810-678-8781
Practice Address - Street 1:3939 S LAPEER RD
Practice Address - Street 2:
Practice Address - City:METAMORA
Practice Address - State:MI
Practice Address - Zip Code:48455-8950
Practice Address - Country:US
Practice Address - Phone:810-678-2331
Practice Address - Fax:810-678-8781
Is Sole Proprietor?:No
Enumeration Date:2011-04-24
Last Update Date:2011-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302021018183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist