Individual
BROOKE VANDERBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3000 N MARKET ST, SHREVEPORT, LA 71107-4062
(318) 424-3251
Mailing address
3000 N MARKET ST, SHREVEPORT, LA 71107-4062
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
020624
LA
Other
Enumeration date
08/22/2014
Last updated
08/22/2014
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