Individual
MRS. MELISSA JEAN HARTMAN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
R.PH.
Contact information
Practice address
4900 SAINT JOE RD, FORT WAYNE STATE DEVELOPMENTAL CENTER PHARMACY, FORT WAYNE, IN 46835-3275
(260) 969-1794
(260) 969-3879
Mailing address
3923 NOTTINGHAM DR, FORT WAYNE, IN 46815-5533
(260) 486-3471
(260) 969-3879
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26015229A
IN
Other
Enumeration date
10/12/2005
Last updated
07/08/2007
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