Individual
GERALD THOMAS CARLSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
410 PILGRIM BLVD, HARTFORD CITY, IN 47348-1382
(765) 331-2120
Mailing address
6013 WYNDHAM WAY, MUNCIE, IN 47304-5790
(765) 702-9452
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26016905A
IN
Other
Enumeration date
07/09/2021
Last updated
07/09/2021
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