Individual
DAX FUITEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM.D
Contact information
Practice address
200 N MAIN ST, EAST PEORIA, IL 61611-2549
(309) 694-1496
Mailing address
200 N MAIN ST, EAST PEORIA, IL 61611-2549
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051-286415
IL
Other
Enumeration date
11/30/2020
Last updated
11/30/2020
About Stedi
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