Individual
NGA VU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4540 HIGHWAY 22, MANDEVILLE, LA 70471-3300
(985) 674-3320
(985) 674-3321
Mailing address
4646 WRIGHT RD, NEW ORLEANS, LA 70128-3039
(504) 813-1366
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
020691
LA
Other
Enumeration date
09/03/2014
Last updated
09/03/2014
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