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Individual

MRS. LYAURO ALICIA VENEGAS JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
101 N MAIN ST, COLUMBIANA, AL 35051-5359
(205) 669-6713
Mailing address
242 BARON DR, CHELSEA, AL 35043-6603
(205) 515-9983

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11185
AL

Other

Enumeration date
07/18/2012
Last updated
07/18/2012
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