Individual
SHOROUQ AL YACOUB I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4950 IRIS AVE APT 734, FORT WAYNE, IN 46825-2777
(308) 293-6240
Mailing address
4950 IRIS AVE APT 734, FORT WAYNE, IN 46825-2777
(308) 293-6240
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26030261A
IN
Other
Enumeration date
02/05/2024
Last updated
02/05/2024
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