Individual
TIFFANY MINICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1013 E LANDRY ST, OPELOUSAS, LA 70570-7388
(337) 942-5738
Mailing address
PO BOX 41, LAWTELL, LA 70550-0041
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PST.021753
LA
Other
Enumeration date
09/13/2016
Last updated
09/13/2016
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