Individual
MARY LA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
800 ROSE ST RM H110, LEXINGTON, KY 40536-0293
(859) 323-4742
Mailing address
800 ROSE ST RM H110, LEXINGTON, KY 40536-0293
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
017732
KY
183500000X
Pharmacist
24988
NC
Other
Enumeration date
06/17/2015
Last updated
06/17/2015
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