Individual
JOHN DEJONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
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
1835P1200X
Pharmacotherapy Pharmacist
Primary
26018160A
IN
Other
Enumeration date
05/01/2014
Last updated
05/01/2014
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