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Individual
LOGAN THIBODEAUX
Active
Individual
LOGAN THIBODEAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
46240
LA
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
46240
LA
Other
Enumeration date
03/27/2013
Last updated
07/27/2013
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