Individual
SUSAN WIDUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
3101 NORTHVIEW DR, ELKHART, IN 46514-6748
(574) 266-5582
(574) 266-7887
Mailing address
3101 NORTHVIEW DR, ELKHART, IN 46514-6748
(574) 266-5582
(574) 266-7887
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26015183A
IN
Other
Enumeration date
08/25/2013
Last updated
08/25/2013
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