Individual
JESSICA H. KOO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8001 BROADWAY, MERRILLVILLE, IN 46410-5500
(219) 736-8067
Mailing address
1025 RESCOBIE CT, SCHERERVILLE, IN 46375-2977
(219) 322-4647
(219) 322-4647
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
051037814
IL
183500000X
Pharmacist
Primary
26016170A
IN
Other
Enumeration date
02/04/2012
Last updated
02/04/2012
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