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1366069379
JORDAN MICHAEL PELTON
FORT WAYNE, IN
NPI
1366069379
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
183500000X Pharmacist
(Licence: MI 5302042475)
Enumeration Date
2020-06-25
Last Update Date
2020-06-25
Business Address
JORDAN MICHAEL PELTON PharmD
2121 LAKE AVE
FORT WAYNE, IN 46805-5100
Phone number: 260-426-5431
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Mailing Address
JORDAN MICHAEL PELTON PharmD
9601 FENWICK LN
NEW HAVEN, IN 46774-1667
Phone number: 419-203-4351
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