Individual
SUSAN EGBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1442 JOSI BLAIR LN, LAKE CHARLES, LA 70605-6590
(337) 401-1556
Mailing address
1442 JOSI BLAIR LN, LAKE CHARLES, LA 70605-6590
(337) 401-1556
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PST.023616
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0
N/A
—
Enumeration date
08/11/2022
Last updated
08/11/2022
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