Individual
LISA WAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
501 S RANCHO DR STE G46, LAS VEGAS, NV 89106-4835
(702) 912-4844
Mailing address
3215 CHELTENHAM ST, LAS VEGAS, NV 89129-7220
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
24318
NV
Other
Enumeration date
10/01/2024
Last updated
10/01/2024
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