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1336846351
LACEY DEYANNE BUCKHANNON
CHAMPAIGN, IL
NPI
1336846351
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Former Name
LACEY DEYANNE HUMES
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
183700000X Pharmacy Technician
(Licence: IL 049137234)
Enumeration Date
2023-02-09
Last Update Date
2023-02-09
Business Address
Mrs. LACEY DEYANNE BUCKHANNON
1509 S NEIL ST
CHAMPAIGN, IL 61820-6580
Phone number: 217-351-1516
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Mailing Address
Mrs. LACEY DEYANNE BUCKHANNON
480 MACON ST
MAHOMET, IL 61853-9421
Phone number: 217-721-8731
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