Individual
DR. DOMINIQUE M MANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3555 GREENWOOD RD, SHREVEPORT, LA 71109-5209
(318) 525-0144
(318) 525-0222
Mailing address
3555 GREENWOOD RD, SHREVEPORT, LA 71109-5209
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PST.019603
LA
Other
Enumeration date
09/22/2011
Last updated
09/22/2011
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