Individual
DR. KIM DIANE EWELLLINDLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
2620 S WESTERN AVE, MARION, IN 46953-3556
(765) 668-0208
Mailing address
2620 S WESTERN AVE, MARION, IN 46953-3556
(765) 668-0208
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26024950A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26024950A
INDIANA BOARD OF PHARMACY
IN
Enumeration date
04/29/2013
Last updated
04/29/2013
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