Individual
CONNIE SHADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
907 S HEATON ST, KNOX, IN 46534-2044
(574) 772-6544
Mailing address
1805 BEECH ST APT 105, VALPARAISO, IN 46383-6396
(260) 547-4106
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26013743A
IN
Other
Enumeration date
11/30/2020
Last updated
11/30/2020
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