Male or Other

Lance Lake RPH

Pharmacist in Ozark, MO(View on Map)

Full Name

Lance Lake RPH

NPI Number

1003196569

NPI Type

Individual Provider

Gender

Male

Enumeration Date

08/27/2011

Specialties

(Taxonomies)

Code

183500000X

Primary Taxonomy

Yes

Licenses

State

Missouri
South Dakota

License Number

2001010937
4847

Contact
Information

Purpose

Mailing
Location

Address

1675 W SOUTH ST
1675 W SOUTH ST

City

Ozark
Ozark

State

MO
MO

Postal Code

65721-5152
65721-5152

Country

US
US

Telephone Number

(417) 485-0762
(417) 485-0762

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 08/27/2011

Provider Address

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