Individual
SHAWN THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6652 YOUREE DR, SHREVEPORT, LA 71105-4630
(318) 795-9966
Mailing address
5368 BLUEBELL DR, BOSSIER CITY, LA 71112-8827
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PST.020577
LA
Other
Enumeration date
08/06/2014
Last updated
08/06/2014
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