Individual
MYRA ROSE COOMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
2420 N LEBANON ST, LEBANON, IN 46052-1183
(765) 482-7021
Mailing address
8930 W 650 S, COLFAX, IN 46035
(765) 418-1704
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26019558A
IN
Other
Enumeration date
12/05/2019
Last updated
12/05/2019
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