Individual
LANCE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
2516 2ND AVE, KEARNEY, NE 68847-4415
(308) 236-8547
Mailing address
2516 2ND AVE, KEARNEY, NE 68847-4415
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14903
NE
Other
Enumeration date
06/25/2015
Last updated
06/25/2015
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