Individual
MRS. ANNA LISA FISHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.PH.
Contact information
Practice address
300 N MAIN ST, EAST PEORIA, IL 61611-2016
(309) 694-7661
Mailing address
2103 DOMINION AVE, PEKIN, IL 61554-1913
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051-036106
IL
Other
Enumeration date
10/12/2011
Last updated
10/12/2011
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