Judy Marie Gravenhorst

NPI #1114557964 in Wabash, Indiana

Provider Information

NPI Number: 1114557964
Entity Type: Individual
Name: Judy Marie Gravenhorst
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pharmacist
Enumeration Date: Jan 21, 2020
Last Updated: Jan 21, 2020

Practice Location

Address: 1309 N CASS ST
City: Wabash
State: Indiana
ZIP Code: 46992-1029
Phone: (260) 563-1612

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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