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CHRIS JOSEPH IVANYISKY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
23515 HWY 190, MANDEVILLE, LA 70470
(985) 626-6300
(985) 626-6639
Mailing address
PO BOX 3850, 23515 HWY 190, MANDEVILLE, LA 70470-3550
(985) 626-6300
(985) 626-6639

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
16117
LA

Other

Enumeration date
04/16/2007
Last updated
07/08/2007
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