Individual
DR. DAN'TREL TY'RIQUE MCCOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1313 PAUL MAILLARD RD, LULING, LA 70070-7000
(985) 785-1753
Mailing address
353 ASH ST, BOUTTE, LA 70039-3144
(504) 274-6706
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PST.024912
LA
Other
Enumeration date
08/16/2023
Last updated
08/16/2023
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