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1699040055
PRAETORIAN RX LLC
TAMPA, FL
NPI
1699040055
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Entity Type
Organization
Authorized Contact
KENNETH DEWAYNE LANIER
President
813-929-0778
Organization Subpart ?
No
Primary Taxonomy
261Q00000X Clinic/Center
Enumeration Date
2012-03-19
Last Update Date
2012-03-19
Business Address
PRAETORIAN RX LLC
20429 AUTUMN FERN AVE
TAMPA, FL 33647-2967
Phone number: 186-623-2877
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Mailing Address
PRAETORIAN RX LLC
20429 AUTUMN FERN AVE
TAMPA, FL 33647-2967
Phone number: 186-623-2877
Copy
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