Individual
MRS. MICHELLE YVETTE REVADER DUNMILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
13500 HIGHWAY 90, BOUTTE, LA 70039-3500
(504) 473-3965
(504) 828-5119
Mailing address
13500 HIGHWAY 90, BOUTTE, LA 70039-3500
(504) 473-3965
(504) 828-5119
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
16445
LA
Other
Enumeration date
08/25/2010
Last updated
08/25/2010
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