Individual
IGNATIUS KIZITO UKATU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1333 PORTAGE AVE, SOUTH BEND, IN 46616-1509
(574) 234-7190
Mailing address
1333 PORTAGE AVE, SOUTH BEND, IN 46616-1509
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26028020A
IN
Other
Enumeration date
12/08/2020
Last updated
12/08/2020
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