Individual
JAMIE SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2103 GAUSE BLVD E, SLIDELL, LA 70461-4229
(985) 643-5743
Mailing address
2103 GAUSE BLVD E, SLIDELL, LA 70461-4229
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
20073
LA
Other
Enumeration date
02/12/2015
Last updated
02/12/2015
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