Individual
MR. MITCHELL ARTHUR HERZOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1207 S HEATON ST, KNOX, IN 46534-2311
(574) 772-4529
(574) 772-7962
Mailing address
1207 S HEATON ST, KNOX, IN 46534-2311
(574) 772-4529
(574) 772-7962
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26018602A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26018602A
STATE LICENSE NUMBER
IN
Enumeration date
01/26/2011
Last updated
01/26/2011
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