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Individual

MATTHEW SCOTT SHORT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARM. D.

Contact information

Practice address
106 E MARKET ST, CRAWFORDSVILLE, IN 47933-1720
(765) 362-1139
Mailing address
106 E MARKET ST, CRAWFORDSVILLE, IN 47933-1720
(765) 362-1139

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26020136A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
26020136A
STATE LICENSE
IN
Enumeration date
04/12/2021
Last updated
04/12/2021
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