Individual
TAD GORDON ITAMURA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
505 E THOMPSON RD, INDIANAPOLIS, IN 46227-1626
(317) 784-9716
(317) 780-7478
Mailing address
11026 TENACIOUS DR, INDIANAPOLIS, IN 46236-9566
(317) 985-2077
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26016350A
IN
Other
Enumeration date
12/03/2020
Last updated
12/03/2020
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