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Individual

MR. DAVID LEE GORTAT

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
R.PH.

Contact information

Practice address
2727 HIGHWAY AVE, PHARMACY, HIGHLAND, IN 46322-1615
(219) 923-2520
(219) 923-2701
Mailing address
2727 HIGHWAY AVE, PHARMACY, HIGHLAND, IN 46322-1615
(219) 923-2520
(219) 923-2701

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26013102A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
26013102A
PHARMACIST LICENSE
IN
Enumeration date
12/09/2005
Last updated
07/08/2007
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