Individual
LISA LE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
467 BROADWAY, REVERE, MA 02151-3030
(781) 286-8656
Mailing address
467 BROADWAY, REVERE, MA 02151-3030
(781) 286-8656
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH236901
MA
Other
Enumeration date
09/09/2016
Last updated
09/09/2016
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