Individual
TRAVIS NGUYEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2661 E US HIGHWAY 30, MERRILLVILLE, IN 46410-5898
(219) 942-0402
Mailing address
2661 E US HIGHWAY 30, MERRILLVILLE, IN 46410-5898
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26025232A
IN
Other
Enumeration date
07/26/2013
Last updated
07/26/2013
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