Individual
MRS. AMANDA KIBODEAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1204 THE BLVD, RAYNE, LA 70578-6219
(337) 334-6611
(337) 334-6614
Mailing address
1204 THE BLVD, RAYNE, LA 70578-6219
(337) 334-6611
(337) 334-6614
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15958
LA
Other
Enumeration date
08/12/2010
Last updated
08/12/2010
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