DR. Latilia Deanne Mack, PHARM.D.

NPI #1295082840 in Eagle Butte, South Dakota

Provider Information

NPI Number: 1295082840
Entity Type: Individual
Name: DR. Latilia Deanne Mack, PHARM.D.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pharmacist
Credential: PHARM.D.
Enumeration Date: Aug 13, 2012
Last Updated: Aug 13, 2012

Practice Location

Address: 24276 166TH ST
Address 2: AIRPORT RD
City: Eagle Butte
State: South Dakota
ZIP Code: 57625
Phone: (605) 964-0650

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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