MR. Laurence Evan Nisonoff, PHARMACIST

NPI #1598043382 in Edwards, Colorado

Provider Information

NPI Number: 1598043382
Entity Type: Individual
Name: MR. Laurence Evan Nisonoff, PHARMACIST
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Pharmacist
Credential: PHARMACIST
Enumeration Date: Jul 27, 2011
Last Updated: Jul 27, 2011

Practice Location

Address: 105 EDWARDS VILLAGE BLVD STE G-107
City: Edwards
State: Colorado
ZIP Code: 81632-9914
Phone: (970) 476-7308

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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