Individual
MS. DEBRA GAIL DOMANGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
1175 AUDUBON AVE, THIBODAUX, LA 70301-4940
(985) 446-3011
(985) 446-3011
Mailing address
300 WAYSIDE DR, HOUMA, LA 70360-6177
(985) 868-5157
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14371
LA
Other
Enumeration date
05/04/2007
Last updated
07/08/2007
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