Withered, Mary Jo
Withered, Mary Jo is an sole proprietor health care provider with primary practice located at 3630 State Road 26 E T-1762, Lafayette IN 47905-4807. She recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as her primary health care specialty. Withered, Mary Jo can be contacted via phone (765) 447-4411.Contact Information
Primary practice address
3630 State Road 26 E T-1762
Lafayette IN 47905-4807
Phone: (765) 447-4411
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Pharmacy Service Providers / Pharmacist | 183500000X | IN26013681A | Indiana |
Profile Details
| NPI number | 1679868285 |
|---|---|
| LBN Legal business name | Withered, Mary Jo |
| Credentials | REGISTERED PHARMACIS |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 10th, 2011 |
| Last updated | Jun 10th, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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