NATHAN LYLE WIEDEMANN

FORT WAYNE, IN
NPI1518485796
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy183500000X Pharmacist
(Licence: IN  26027384A)
Enumeration Date2017-09-07
Last Update Date2022-12-16
Business Address
NATHAN LYLE WIEDEMANN
11932 LIMA RD
FORT WAYNE, IN 46818-8658
Phone number: 260-637-6667
Mailing Address
NATHAN LYLE WIEDEMANN
11932 LIMA RD
FORT WAYNE, IN 46818-8658
Phone number: 260-637-6667