Individual
JORDAN LEE LASATER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2300 RAMSEY ST, FAYETTEVILLE, NC 28301-3856
(910) 488-2120
Mailing address
2300 RAMSEY ST, FAYETTEVILLE, NC 28301-3856
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
18864
NC
Other
Enumeration date
04/04/2012
Last updated
04/16/2019
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