Individual
DR. MANDY FAITH ANTKIEWICZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
3500 CENTRAL AVE, LAKE STATION, IN 46405-2271
(219) 963-7355
(219) 963-1562
Mailing address
3500 CENTRAL AVE, LAKE STATION, IN 46405-2271
(219) 963-7355
(219) 963-1562
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26021689A
IN
Other
Enumeration date
12/07/2011
Last updated
12/07/2011
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