Individual
GREGORY RUSSELL PORET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BS
Contact information
Practice address
1007 SYCAMORE ST, COTTONPORT, LA 71327-3403
(318) 876-2104
(318) 876-3964
Mailing address
PO BOX 127, COTTONPORT, LA 71327-0127
(318) 876-2104
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10986
LA
Other
Enumeration date
02/21/2022
Last updated
02/21/2022
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