Individual
MARY KATHLEEN GORTAT
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
2727 HIGHWAY AVE, HIGHLAND, IN 46322-1615
(219) 972-3506
Mailing address
8937 LIABLE RD, HIGHLAND, IN 46322-2265
(219) 972-3506
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26013351A
IN
Other
Enumeration date
04/07/2006
Last updated
07/08/2007
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