Individual
WADE LEWIS BOUGHMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
4750 E 450 S STE A, WHITESTOWN, IN 46075-8404
(765) 748-8248
Mailing address
4750 E 450 S STE A, WHITESTOWN, IN 46075-8404
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26019553A
IN
Other
Enumeration date
11/18/2024
Last updated
11/18/2024
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