Individual
LAILANE LAZARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1501 BROAD RIVER RD, COLUMBIA, SC 29210-7301
(803) 561-0515
(803) 750-8128
Mailing address
1501 BROAD RIVER ROAD, COLUMBIA, SC 29210
(803) 561-0515
(803) 750-8128
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
7235
SC
Other
Enumeration date
06/15/2010
Last updated
06/15/2010
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