Individual
LORA LEE VAN DYKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM D
Contact information
Practice address
2333 W 57TH ST STE 109, SIOUX FALLS, SD 57108-5054
(605) 331-3190
(605) 978-3996
Mailing address
2333 W 57TH ST STE 109, SIOUX FALLS, SD 57108-5054
(605) 331-3190
(605) 978-3996
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
118797
MN
183500000X
Pharmacist
19216
IA
183500000X
Pharmacist
Primary
4117
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4117
PHARMACIST LICENSE
SD
Enumeration date
01/19/2012
Last updated
03/04/2021
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