Individual
ERIC LORENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
412 EAGLERIDGE BLVD, PUEBLO, CO 81008-2100
(719) 553-0914
Mailing address
412 EAGLERIDGE BLVD, PUEBLO, CO 81008-2100
(719) 553-0914
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PHA.0020069
CO
Other
Enumeration date
04/16/2019
Last updated
04/16/2019
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