Individual
MR. KEVIN KENT MIANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1830 W AIRLINE HWY, LA PLACE, LA 70068-3335
(985) 653-9974
(985) 653-9980
Mailing address
39704 ROU MAR NEI DR, PONCHATOULA, LA 70454-6485
(985) 370-5767
(985) 653-9980
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10569
LA
Other
Enumeration date
08/31/2006
Last updated
07/08/2007
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