Individual
NATHAN L DICKISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1323 N BALDWIN AVE, MARION, IN 46952-1913
(765) 664-2434
(765) 664-3721
Mailing address
7311 E 600 N, PO BOX 173, VAN BUREN, IN 46991-9728
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26018934A
IN
Other
Enumeration date
10/24/2011
Last updated
10/24/2011
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