Dale William Widman

NPI #1891078887 in Portland, Indiana

Provider Information

NPI Number: 1891078887
Entity Type: Individual
Name: Dale William Widman
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pharmacist
Enumeration Date: Sep 26, 2011
Last Updated: Sep 26, 2011

Practice Location

Address: 124 W VOTAW ST
City: Portland
State: Indiana
ZIP Code: 47371-1143
Phone: (260) 726-2049

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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