Provider Demographics
NPI:1316202732
Name:SPERL, LOIS A (RPH)
Entity Type:Individual
Prefix:MS
First Name:LOIS
Middle Name:A
Last Name:SPERL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3827 MARKETPLACE DR NW
Mailing Address - Street 2:TARGET #1351
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-3192
Mailing Address - Country:US
Mailing Address - Phone:507-536-3898
Mailing Address - Fax:
Practice Address - Street 1:3827 MARKETPLACE DR NW
Practice Address - Street 2:TARGET #1351
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-3192
Practice Address - Country:US
Practice Address - Phone:507-536-3898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-11
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN111618183500000X
WI10557-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist