Individual
DEBORAH J WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.PH.
Contact information
Practice address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 221-8411
(318) 429-5750
Mailing address
2175 STOCKWELL RD APT 122, BOSSIER CITY, LA 71111-5773
(318) 834-0835
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9479
AL
Other
Enumeration date
08/15/2006
Last updated
07/08/2007
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