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1396028171
PATRICK DEWAYNE SHANNON
FORT WAYNE, IN
NPI
1396028171
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
183500000X Pharmacist
(Licence: IN 26018335a)
Enumeration Date
2011-09-27
Last Update Date
2011-09-27
Business Address
Mr. PATRICK DEWAYNE SHANNON
110 E CREIGHTON AVE
FORT WAYNE, IN 46803-3344
Phone number: 260-456-1841
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Mailing Address
Mr. PATRICK DEWAYNE SHANNON
6219 WILMARBEE DR
FORT WAYNE, IN 46804-1543
Phone number: 260-433-5409
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