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Individual

LISA ANN COLSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RPH

Contact information

Practice address
342 MASSACHUSETTS AVE, SUITE 103, INDIANAPOLIS, IN 46204-2146
(317) 631-6000
(317) 631-6004
Mailing address
342 MASSACHUSETTS AVE, SUITE 103, INDIANAPOLIS, IN 46204-2146
(317) 631-6000
(317) 631-6004

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26017612A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
26017612A
STATE LICENSE
IN
Enumeration date
12/31/2012
Last updated
12/31/2012
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