Individual
NATHAN SHROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD.
Contact information
Practice address
2 S BROADWAY, PERU, IN 46970-2232
(765) 472-4367
Mailing address
4178 N STATE ROAD 19, PERU, IN 46970-8654
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26026594A
IN
Other
Enumeration date
12/05/2020
Last updated
12/05/2020
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