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Individual

MISS LISA ARLENE GORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RPH

Contact information

Practice address
3200 PROVIDENCE DR, ANCHORAGE, AK 99508-4615
(907) 261-3633
Mailing address
PO BOX 671129, CHUGIAK, AK 99567-1129
(907) 688-6468
(907) 688-6469

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
0000007877
TN
183500000X
Pharmacist
Primary
1100
AK
183500000X
Pharmacist
RPH015603
GA

Other

Enumeration date
04/11/2007
Last updated
07/08/2007
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