Individual
DANIEL FORSYTHE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1801 SOUTH ST, LAFAYETTE, IN 47904-2962
(765) 448-1366
Mailing address
704 SHADY CREEK DR, LAFAYETTE, IN 47905-7508
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26022791A
IN
Other
Enumeration date
08/27/2011
Last updated
08/27/2011
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