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Individual

JODI LYNN HICKS I

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4522 ELKHART RD, GOSHEN, IN 46526-5822
(574) 875-3010
(574) 875-3065
Mailing address
4522 ELKHART RD, GOSHEN, IN 46526-5822
(574) 875-3010
(574) 875-3065

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26017560A
IN

Other

Enumeration date
05/31/2016
Last updated
05/31/2016
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