Individual
AUSTIN HARTZOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
5110 VALUE DRIVE, FORT WAYNE, IN 46808
(260) 481-1110
Mailing address
2201 SPRINGFIELD AVE, FORT WAYNE, IN 46805-1541
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26028740A
IN
Other
Enumeration date
08/21/2020
Last updated
08/21/2020
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