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General NPI Number Information
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NPI Number | 1811489800
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Entity Type | Individual
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Provider Name | MR. COLIN LAIRD
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Gender | Male
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Dates
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Enumeration Date | 06/05/2018
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Last Update Date | 06/05/2018
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Provider Practice Location Address
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Address Line | 3432 ROUTE 764 SUGAR RUN PLAZA CARDINAL HEALTH
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City | DUNCANSVILLE
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State | PA
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Zip | 16635
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Country | US
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Telephone | 814-942-2545
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Fax |
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Provider Business Mailing Address
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Address Line | 133 BEAVER CREEK RD
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City | LOYSBURG
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State | PA
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Zip | 16659-9626
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Country | US
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Telephone | 814-766-3208
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835N0905X
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Taxonomy Name | Nuclear Pharmacist
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License Number | RP043982L
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License Number State | PA
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