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Individual

MR. THOMAS RICHARD HAUCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
2121 LAKE AVE, FORT WAYNE, IN 46805-5100
(260) 426-5431
(260) 460-1474
Mailing address
4314 HIGHWOOD DR, FORT WAYNE, IN 46815-5963
(260) 482-9324

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26015632A
IN

Other

Enumeration date
08/18/2006
Last updated
07/08/2007
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