Individual
DR. THOMAS EDWARD LACKNER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1372 138TH LN NW, ANDOVER, MN 55304-4095
(763) 755-3662
Mailing address
1372 138TH LN NW, ANDOVER, MN 55304-4095
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
1131677
MN
Other
Enumeration date
07/05/2005
Last updated
07/08/2007
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