Individual
LAUREN LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1330 MARTIN BLVD, MIDDLE RIVER, MD 21220-4104
(410) 406-9082
Mailing address
1330 MARTIN BLVD, MIDDLE RIVER, MD 21220-4104
(410) 406-9082
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
T09985
MD
Other
Enumeration date
01/29/2015
Last updated
01/29/2015
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