Provider Demographics
NPI:1437265691
Name:LECHTENBERG, MATTHEW DAVID (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:DAVID
Last Name:LECHTENBERG
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1537 LEGEND TRAIL DR UNIT B
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66047-2562
Mailing Address - Country:US
Mailing Address - Phone:785-350-3111
Mailing Address - Fax:785-350-4702
Practice Address - Street 1:2200 SW GAGE BLVD
Practice Address - Street 2:119 - PHARMACY
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66622-0001
Practice Address - Country:US
Practice Address - Phone:785-350-3111
Practice Address - Fax:785-350-4702
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-13484183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist