Individual
DR. KY THAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
167 NORTHSHORE BLVD, SLIDELL, LA 70460-6836
(985) 690-0128
Mailing address
167 NORTHSHORE BLVD, SLIDELL, LA 70460-6836
(985) 690-0128
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
020292
LA
Other
Enumeration date
09/07/2013
Last updated
08/19/2014
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