Individual
KRISTA MOTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
6309 LIMA RD, FORT WAYNE, IN 46818-1425
(260) 497-1010
Mailing address
1407 SEVAN LAKE CT, FORT WAYNE, IN 46825-7233
(260) 438-5671
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26018640A
IN
Other
Enumeration date
11/26/2020
Last updated
11/09/2021
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