Lance Lake, RPH

NPI #1003196569 in Ozark, Missouri

Provider Information

NPI Number: 1003196569
Entity Type: Individual
Name: Lance Lake, RPH
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Pharmacist
Credential: RPH
Enumeration Date: Aug 27, 2011
Last Updated: Aug 27, 2011

Practice Location

Address: 1675 W SOUTH ST
City: Ozark
State: Missouri
ZIP Code: 65721-5152
Phone: (417) 485-0762

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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