Individual
MRS. JAYNE WALLACE DISHMAN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
308 N LEWIS ST, NEW IBERIA, LA 70563-2843
(337) 364-7671
(337) 365-0563
Mailing address
607 OAK MANOR DR, NEW IBERIA, LA 70563-2223
(337) 369-9783
(337) 365-0563
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15565
LA
Other
Enumeration date
08/24/2005
Last updated
07/08/2007
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