Individual
DR. SONG Y LAVALAIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
902 E LINCOLN RD, IDABEL, OK 74745-7337
(580) 286-2600
(580) 286-4714
Mailing address
902 E LINCOLN RD, IDABEL, OK 74745-7337
(580) 286-2600
(580) 286-4714
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14364
OK
Other
Enumeration date
04/16/2010
Last updated
04/16/2010
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