Individual
LISA MARLIS SANDBO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
342 MASSACHUSETTS AVENUE, SUITE 103, INDIANAPOLIS, IN 46204
(317) 631-6000
(317) 631-6004
Mailing address
342 MASSACHUSETTS AVENUE, SUITE 103, INDIANAPOLIS, IN 46204
(317) 631-6000
(317) 631-6004
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26017201A
IN
183500000X
Pharmacist
43798
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26017201A
STATE LICENSE
IN
01
—
43798
STATE LICENSE
CA
Enumeration date
12/27/2012
Last updated
12/27/2012
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