Individual
BLAKE BURTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
11109 PARKVIEW PLAZA DR, FORT WAYNE, IN 46845-1701
(260) 266-1000
Mailing address
366 RAYS CREEK WAY, FORT WAYNE, IN 46825-8109
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
8647026-1701
UT
Other
Enumeration date
08/31/2018
Last updated
08/31/2018
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