Individual
KENNETH RAY PEARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
226 N HALLECK ST, DEMOTTE, IN 46310-8633
(219) 987-4900
Mailing address
11118 WOODSIDE DR, DEMOTTE, IN 46310-7801
(219) 987-8120
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26018653A
IN
Other
Enumeration date
09/22/2011
Last updated
09/22/2011
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