Individual
LAINE MADISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
800 ZORN AVE, LOUISVILLE, KY 40206-1433
(502) 287-6431
Mailing address
4255A N STATE ROUTE 1 17, MOMENCE, IL 60954-3484
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051304324
IL
Other
Enumeration date
11/22/2022
Last updated
11/22/2022
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