Individual
JORDAN MICHAEL PELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
2121 LAKE AVE, FORT WAYNE, IN 46805-5100
(260) 426-5431
Mailing address
9601 FENWICK LN, NEW HAVEN, IN 46774-1667
(419) 203-4351
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302042475
MI
Other
Enumeration date
06/25/2020
Last updated
06/25/2020
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