Individual
MATTHEW ALAN KWIATKOWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2121 LAKE AVE, FORT WAYNE, IN 46805-5100
(260) 426-5431
Mailing address
2121 LAKE AVE, FORT WAYNE, IN 46805-5100
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
03233198
OH
Other
Enumeration date
11/16/2015
Last updated
11/16/2015
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