Individual
BRENDA LEE HARTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2200 RANDALLIA DR, FORT WAYNE, IN 46805-4638
(260) 373-3469
(260) 373-3418
Mailing address
2200 RANDALLIA DR, FORT WAYNE, IN 46805-4699
(260) 373-3469
(260) 373-3418
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
03317216
OH
183500000X
Pharmacist
Primary
26016240A
IN
Other
Enumeration date
05/12/2018
Last updated
05/12/2018
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