Individual
LYDIA BARHAM OSWALT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3810 JEWELLA AVE, SHREVEPORT, LA 71109-4706
(318) 631-9010
Mailing address
2010 PINE RIDGE WAY, BENTON, LA 71006-3488
(318) 965-4173
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11694
LA
Other
Enumeration date
04/18/2011
Last updated
04/18/2011
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