Individual
NICHOLAS SELBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6220 SAINT JOE CENTER RD, FORT WAYNE, IN 46835-2506
(260) 485-7998
Mailing address
6220 SAINT JOE CENTER RD, FORT WAYNE, IN 46835-2506
(260) 485-7998
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
051300874
IL
183500000X
Pharmacist
260274948
IN
183500000X
Pharmacist
Primary
26027494A
IN
Other
Enumeration date
07/23/2019
Last updated
08/22/2019
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