Individual
MR. BRIAN THOMAS MCDONOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
805 S LAKE ST, GARY, IN 46403-2918
(219) 938-4857
(219) 938-4809
Mailing address
12705 MORNING DOVE DR, CEDAR LAKE, IN 46303-8607
(219) 374-8824
(219) 374-8824
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26017473A
IN
Other
Enumeration date
07/31/2007
Last updated
07/31/2007
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