Provider Demographics
NPI:1932417029
Name:MAROTTI, LAICY (PHARMD)
Entity Type:Individual
Prefix:
First Name:LAICY
Middle Name:
Last Name:MAROTTI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 SUMMIT ST
Mailing Address - Street 2:
Mailing Address - City:MARSHALLTOWN
Mailing Address - State:IA
Mailing Address - Zip Code:50158-5484
Mailing Address - Country:US
Mailing Address - Phone:641-753-4424
Mailing Address - Fax:641-844-6327
Practice Address - Street 1:1301 SUMMIT ST
Practice Address - Street 2:
Practice Address - City:MARSHALLTOWN
Practice Address - State:IA
Practice Address - Zip Code:50158-5484
Practice Address - Country:US
Practice Address - Phone:641-753-4424
Practice Address - Fax:641-844-6327
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-22
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA19699183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist