Individual
JACK ANTONIO AVILES AGUILAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2320 CUNNINGHAM RD, INDIANAPOLIS, IN 46224-3702
(317) 241-6374
Mailing address
1708 BOCA RATON BLVD, KOKOMO, IN 46902-3159
(765) 271-6652
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26030907A
IN
Other
Enumeration date
08/28/2024
Last updated
08/28/2024
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