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1518485796
NATHAN LYLE WIEDEMANN
FORT WAYNE, IN
NPI
1518485796
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
183500000X Pharmacist
(Licence: IN 26027384A)
Enumeration Date
2017-09-07
Last Update Date
2022-12-16
Business Address
NATHAN LYLE WIEDEMANN
11932 LIMA RD
FORT WAYNE, IN 46818-8658
Phone number: 260-637-6667
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Mailing Address
NATHAN LYLE WIEDEMANN
11932 LIMA RD
FORT WAYNE, IN 46818-8658
Phone number: 260-637-6667
Copy
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