Provider Demographics
NPI:1881916773
Name:ALLARD, RAYMOND TODD (RPH)
Entity type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:TODD
Last Name:ALLARD
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22801 HARPER AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48080-1848
Mailing Address - Country:US
Mailing Address - Phone:586-779-4340
Mailing Address - Fax:586-779-4882
Practice Address - Street 1:22801 HARPER AVE
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48080-1848
Practice Address - Country:US
Practice Address - Phone:586-779-4340
Practice Address - Fax:586-779-4882
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-19
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302023066183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist