Individual
MIRANDA REXROAT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
105 N PARK AVE, ALEXANDRIA, IN 46001-2055
(765) 724-2210
Mailing address
105 N PARK AVE, ALEXANDRIA, IN 46001-2055
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26022046A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00
00
—
Enumeration date
01/07/2021
Last updated
01/07/2021
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