PATRICK DEWAYNE SHANNON

FORT WAYNE, IN
NPI1396028171
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy183500000X Pharmacist
(Licence: IN  26018335a)
Enumeration Date2011-09-27
Last Update Date2011-09-27
Business Address
Mr. PATRICK DEWAYNE SHANNON
110 E CREIGHTON AVE
FORT WAYNE, IN 46803-3344
Phone number: 260-456-1841
Mailing Address
Mr. PATRICK DEWAYNE SHANNON
6219 WILMARBEE DR
FORT WAYNE, IN 46804-1543
Phone number: 260-433-5409