Individual
AMANDA LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1501 EAST MAIN STREET, RICHMOND, IN 47374
(765) 962-8822
Mailing address
1501 EAST MAIN STREET, RICHMOND, IN 47374
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26027902A
IN
Other
Enumeration date
12/03/2020
Last updated
12/03/2020
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