Individual
MR. EDMOND GABRIEL DUCOTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
3124 LINE AVE, SHREVEPORT, LA 71104-4240
(318) 222-4807
(318) 872-5816
Mailing address
9621 NORRIS FERRY RD, SHREVEPORT, LA 71106-7719
(318) 797-9302
(318) 797-9302
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15919
LA
Other
Enumeration date
08/21/2011
Last updated
08/21/2011
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