NPI 1134465701

Lance M Golly

Practitioner Pharmacist Burlington, IA

Practice location

Address: 3245 Agency St, Burlington, IA 52601-1993
Phone: (319) 758-9991
Fax: (319) 758-9989

Registered specialties

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence 17685 (IA)

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Registry record

NPI: 1134465701
Entity type: Individual
Sex (as registered): Male
NPI issued: 29 Dec 2012
Record last updated: 29 Dec 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.