Individual
DR. TRAVIS OWEN LACORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
113 NORTH 3RD STREET, KIESTER, MN 56051
(507) 459-8421
(641) 298-1204
Mailing address
P.O. BOX 357, 113 NORTH 3RD STREET, KIESTER, MN 56051
(507) 459-8421
(641) 298-1204
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
118237
MN
183500000X
Pharmacist
21210
IA
183500000X
Pharmacist
5416
SD
Other
Enumeration date
07/05/2012
Last updated
07/05/2012
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