| NPI | 1831499151 |
|---|---|
| Other Name | LEE ANNE MATHENA TADLOCK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 19781) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 31770) |
| Enumeration Date | 2010-11-03 |
| Last Update Date | 2017-03-23 |