Individual
MR. LANE ALLEN BALLANDBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
140 W 14TH ST, BROWER DRUG CO, ST ANSGAR, IA 50472
(641) 713-4381
(641) 713-2386
Mailing address
209 9TH ST N, NORTHWOOD, IA 50459
(641) 324-2622
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
114593
MN
183500000X
Pharmacist
Primary
15695
IA
183500000X
Pharmacist
715
AK
Other
Enumeration date
06/06/2007
Last updated
07/08/2007
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