Individual
MRS. BRANDY LYNN ROUSSEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7015 PARK AVE, HOUMA, LA 70364-2850
(985) 879-2407
Mailing address
300 MADEWOOD DR, DESTREHAN, LA 70047-6127
(504) 261-0260
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
18276
LA
Other
Enumeration date
09/29/2011
Last updated
09/29/2011
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