Individual
MR. LANCE M GOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3245 AGENCY ST, BURLINGTON, IA 52601-1993
(319) 758-9991
(319) 758-9989
Mailing address
3245 AGENCY ST, BURLINGTON, IA 52601-1993
(319) 758-9991
(319) 758-9989
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17685
IA
Other
Enumeration date
12/29/2012
Last updated
12/29/2012
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