Provider Demographics
NPI:1568510915
Name:LAVOI, JODY M (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JODY
Middle Name:M
Last Name:LAVOI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:JODY
Other - Middle Name:M
Other - Last Name:LAVOI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:525 MAIN ST W
Mailing Address - Street 2:
Mailing Address - City:MELROSE
Mailing Address - State:MN
Mailing Address - Zip Code:56352-1043
Mailing Address - Country:US
Mailing Address - Phone:320-256-1824
Mailing Address - Fax:320-200-3244
Practice Address - Street 1:525 MAIN ST W
Practice Address - Street 2:
Practice Address - City:MELROSE
Practice Address - State:MN
Practice Address - Zip Code:56352-1043
Practice Address - Country:US
Practice Address - Phone:320-256-1824
Practice Address - Fax:320-200-3244
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2019-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN118710183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist