Individual
LORI ANN MADDOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
423 W 4TH ST, GRAND ISLAND, NE 68801-4503
(308) 384-7372
Mailing address
1303 JACKSON ST, SAINT PAUL, NE 68873-1021
(308) 750-0707
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10107
NE
Other
Enumeration date
04/21/2021
Last updated
04/21/2021
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