Individual
JOHN LICHTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7501 HICKMAN RD, URBANDALE, IA 50322-4603
(515) 276-6712
Mailing address
7501 HICKMAN RD, URBANDALE, IA 50322
(515) 276-6712
Taxonomy
Speciality
Code
Description
License number
State
1835P2201X
Ambulatory Care Pharmacist
Primary
15955
IA
Other
Enumeration date
12/23/2015
Last updated
12/23/2015
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