Individual
MR. STACY LANE OSMUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
316 W ASPEN AVE, FRUITA, CO 81521-2504
(970) 858-0147
Mailing address
3010 OAKWOOD DR, GRAND JUNCTION, CO 81504-3500
(303) 908-4764
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
13417
CO
Other
Enumeration date
10/28/2011
Last updated
01/26/2020
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