Individual
SHANNON SUE FRIEDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
226 N HALLECK ST, DEMOTTE, IN 46310-8633
(219) 987-4900
Mailing address
7919 W 1400 N, DEMOTTE, IN 46310-8335
(219) 987-5202
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26019292A
IN
Other
Enumeration date
10/16/2011
Last updated
10/16/2011
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