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Individual

MR. KENNETH WIMBISH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1200 W OAK ST, AMITE, LA 70422-2762
(985) 748-7731
(985) 740-7731
Mailing address
37310 HIGHWAY 10, FRANKLINTON, LA 70438-3297
(985) 974-5029

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
017030
LA

Other

Enumeration date
05/19/2014
Last updated
05/19/2014
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