Individual
MRS. MELODIE GOETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2121 LAKE AVE, FORT WAYNE, IN 46805-5100
(260) 426-5431
Mailing address
2121 LAKE AVE, FORT WAYNE, IN 46805-5100
(260) 426-5431
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26015552A
IN
Other
Enumeration date
08/27/2007
Last updated
08/27/2007
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