Provider Demographics
NPI:1447559521
Name:VO, LAN P (RPH)
Entity Type:Individual
Prefix:
First Name:LAN
Middle Name:P
Last Name:VO
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 1:508 S LEWIS ST
Mailing Address - Street 2:
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70560-4819
Mailing Address - Country:US
Mailing Address - Phone:404-664-8659
Mailing Address - Fax:
Practice Address - Street 1:1108 E MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70560-3920
Practice Address - Country:US
Practice Address - Phone:337-365-4514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-15
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA13034183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist