Individual
JONATHAN MATTHEW LANDRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
103 E MAIN ST, BROUSSARD, LA 70518-4616
(337) 839-8880
(337) 839-8881
Mailing address
103 E MAIN ST, BROUSSARD, LA 70518-4616
(337) 839-8880
(337) 839-8881
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PST.023104
LA
Other
Enumeration date
08/02/2019
Last updated
08/02/2019
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