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1609176551
SHANE KORTAN
LAKE HAVASU CITY, AZ
NPI
1609176551
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
183500000X Pharmacist
(Licence: AZ s012216)
Enumeration Date
2010-10-26
Last Update Date
2010-10-26
Business Address
-- SHANE KORTAN RPh.
1650 MCCULLOCH BLVD N
LAKE HAVASU CITY, AZ 86403-0961
Phone number: 928-855-9200
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Mailing Address
-- SHANE KORTAN RPh.
1650 MCCULLOCH BLVD N
LAKE HAVASU CITY, AZ 86403-0961
Phone number: 928-855-9200
Copy
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