Individual
ANGELIQUE LE ROUX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
19205 HIGHWAY 12, SONOMA, CA 95476-5413
(707) 938-0281
Mailing address
2500 DEER VALLEY RD, APT 827, SAN RAFAEL, CA 94903-1935
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
62268
CA
Other
Enumeration date
08/25/2010
Last updated
08/25/2010
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