Individual
JEREMY J BLOSSER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
6317 E 350 N, ROLLING PRAIRIE, IN 46371-9469
(574) 520-9413
Mailing address
6317 E 350 N, ROLLING PRAIRIE, IN 46371-9469
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26024173A
IN
Other
Enumeration date
10/23/2011
Last updated
10/23/2011
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