Individual
CASEY ALLEN LESNAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1720 S SYCAMORE AVE, SIOUX FALLS, SD 57110-4207
(605) 221-0782
(605) 221-0839
Mailing address
1720 S SYCAMORE AVE, SIOUX FALLS, SD 57110-4207
(605) 221-0782
(605) 221-0839
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5402
SD
Other
Enumeration date
08/15/2011
Last updated
08/15/2011
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