Individual
MRS. LISA MICHELLE BLOEBAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
505 COLLEGE AVE, VINCENNES, IN 47591
(812) 882-3896
(812) 882-0978
Mailing address
505 COLLEGE AVE, VINCENNES, IN 47591
(812) 882-3896
(812) 882-0978
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26021096A
IN
Other
Enumeration date
09/28/2011
Last updated
09/28/2011
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