Individual
LAZONDRA S MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
1920 DOUGLAS AVE, RACINE, WI 53402-4614
(262) 633-4948
Mailing address
1920 DOUGLAS AVE, RACINE, WI 53402-4614
(262) 634-4948
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
1305140
WI
Other
Enumeration date
10/20/2011
Last updated
10/20/2011
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