Individual
RYAN HAYDEN LACKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
111 COLCHESTER AVE, BURLINGTON, VT 05401-1473
(802) 847-2821
(802) 847-5958
Mailing address
111 COLCHESTER AVE, BURLINGTON, VT 05401-1473
(802) 847-2821
(802) 847-5958
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
1439811
VT
Other
Enumeration date
07/19/2022
Last updated
08/23/2022
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