Individual
JESSICA CZAJKOWSKI VERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4403 W WESTERN AVE, SOUTH BEND, IN 46619-2640
(574) 234-3241
Mailing address
4403 W WESTERN AVE, SOUTH BEND, IN 46619-2640
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26029849A
IN
Other
Enumeration date
10/17/2022
Last updated
10/17/2022
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