Individual
LISA ANNE MANDEVILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD RPH
Contact information
Practice address
60 W BROMLEY LN, BRIGHTON, CO 80601-3026
(303) 659-2510
Mailing address
60 W BROMLEY LN, BRIGHTON, CO 80601-3026
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
19451
CO
Other
Enumeration date
08/16/2017
Last updated
08/16/2017
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