Individual
SAMANTHA THIAVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4901 PRYTANIA ST, NEW ORLEANS, LA 70115-4017
(504) 891-6307
Mailing address
513 WIEGAND DR, WESTWEGO, LA 70094-3065
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PST.022110
LA
Other
Enumeration date
08/13/2017
Last updated
08/13/2017
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