Provider Demographics
NPI:1679782593
Name:GUICE, MICHELLE LEIGH (PHARMD)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LEIGH
Last Name:GUICE
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 1:2201 CENTURY COURT, SE
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601
Mailing Address - Country:US
Mailing Address - Phone:256-350-3003
Mailing Address - Fax:
Practice Address - Street 1:824 6TH AVE SE
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-3022
Practice Address - Country:US
Practice Address - Phone:256-351-0404
Practice Address - Fax:256-351-2073
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL13425183500000X
TN9994183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist