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Individual

MR. CHARLES DAVID COLLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
R.PH.

Contact information

Practice address
1514 SAMPSON ST # 1, WESTLAKE, LA 70669-4632
(337) 433-1742
Mailing address
1134 CAESARS CT, LAKE CHARLES, LA 70611-6739
(337) 217-1524

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
016137
LA

Other

Enumeration date
03/02/2018
Last updated
03/02/2018
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