Individual
PHIL H WALTZ JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
200 N TRENTON ST, RUSTON, LA 71270-4324
(318) 255-0458
(318) 251-3373
Mailing address
2102 KNOWLES DR, RUSTON, LA 71270-2619
(318) 255-0659
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9728
LA
Other
Enumeration date
11/18/2009
Last updated
11/18/2009
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