Jeremy Lisman

NPI #1306128921 in Kingston, Pennsylvania

Provider Information

NPI Number: 1306128921
Entity Type: Individual
Name: Jeremy Lisman
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Pharmacist
Enumeration Date: Sep 10, 2011
Last Updated: Sep 10, 2011

Practice Location

Address: 201 WYOMING AVE
City: Kingston
State: Pennsylvania
ZIP Code: 18704-3501
Phone: (570) 283-8267

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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