Individual
MITCHELL CHARLES FAIRBROTHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
8405 SOUTHEASTERN AVE, INDIANAPOLIS, IN 46239-1348
(317) 862-2414
Mailing address
8405 SOUTHEASTERN AVE, INDIANAPOLIS, IN 46239-1348
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26028582A
IN
Other
Enumeration date
11/27/2020
Last updated
11/27/2020
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