Individual
MRS. LISA H. WAGUESPACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
1625 ST, MARY STREET, THIBODAUX, LA 70301
(985) 493-6981
Mailing address
1625 ST. MARY STREET, THIBODAUX, LA 70301
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11771
LA
Other
Enumeration date
10/01/2014
Last updated
10/01/2014
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