Individual
ALICIA WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2012 N WAYNE ST, ANGOLA, IN 46703-9102
(260) 665-5560
Mailing address
2012 N WAYNE ST, ANGOLA, IN 46703-9102
(260) 665-5560
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26025720A
IN
Other
Enumeration date
07/29/2014
Last updated
12/28/2020
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