Individual
VICTOR SO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3551 CASSOPOLIS ST, ELKHART, IN 46514-6743
(224) 392-1799
Mailing address
6030 MISSION TRL APT 5, GRANGER, IN 46530-4025
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26025251A
IN
Other
Enumeration date
09/11/2013
Last updated
09/11/2013
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