Individual
TRICIA DIANE KUSTRIC X
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2272 N MAIN ST, CROWN POINT, IN 46307-1802
(219) 661-5601
Mailing address
2272 N MAIN ST, CROWN POINT, IN 46307-1802
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2601223A
IN
Other
Enumeration date
01/06/2020
Last updated
01/06/2020
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