Individual
DEREK STREETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6745 E SOUTHPORT RD, INDIANAPOLIS, IN 46237-9728
(317) 887-0691
Mailing address
6745 E SOUTHPORT RD, INDIANAPOLIS, IN 46237-9728
(317) 887-0691
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26028797A
IN
Other
Enumeration date
07/03/2020
Last updated
07/03/2020
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