Individual
DAVID JOHANN LEBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4120 N CLINTON ST, FORT WAYNE, IN 46805
(260) 483-3185
Mailing address
4120 N CLINTON ST, FORT WAYNE, IN 46805-1230
(260) 484-9348
(260) 969-5929
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26016364A
IN
Other
Enumeration date
12/02/2019
Last updated
12/02/2019
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