Individual
WACEY TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7004 YOUREE DR, SHREVEPORT, LA 71105-5109
(318) 797-3665
Mailing address
7004 YOUREE DR, SHREVEPORT, LA 71105-5109
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
023385
LA
Other
Enumeration date
05/06/2020
Last updated
05/06/2020
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