Organization
ATHLETE PHARMACIST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK V LORSON II PHARMD, CGP (CEO)
(414) 207-0309
Entity
Organization
Contact information
Practice address
211 NAUTILUS DR APT 8, MADISON, WI 53705-4358
(414) 207-0309
Mailing address
211 NAUTILUS DR APT 8, MADISON, WI 53705-4358
(414) 207-0309
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
261QP0905X
State or Local Public Health Clinic/Center
—
—
Other
Enumeration date
09/13/2012
Last updated
09/13/2012
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