Individual
DR. LISA ANNE BOOTHBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM.D., BCPS
Contact information
Practice address
275 W 12TH ST, PERU, IN 46970-1638
(765) 472-8004
Mailing address
2020 E LOU LN, PERU, IN 46970-8652
(765) 460-5066
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
26023438A
IN
1835P1200X
Pharmacotherapy Pharmacist
PS34954
FL
1835P1200X
Pharmacotherapy Pharmacist
RPH020650
GA
Other
Enumeration date
01/23/2007
Last updated
12/20/2010
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