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Individual

LAURA A SHULL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
218 E PETTIT AVE, FORT WAYNE, IN 46806-3038
(260) 456-4736
(260) 744-5053
Mailing address
218 E PETTIT AVE, FORT WAYNE, IN 46806-3038
(260) 456-4736
(260) 744-5053

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26016090A
IN

Other

Enumeration date
11/22/2019
Last updated
11/22/2019
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