Individual
LAVONNE ISAAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
512 BROADWAY, CENTERVILLE, SD 57014-0070
(605) 563-2243
(605) 563-3784
Mailing address
141 DAKOTA STREET, CENTERVILLE, SD 57014
(605) 563-2116
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
T-0301
SD
Other
Enumeration date
09/06/2006
Last updated
07/08/2007
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