Individual
PENNY KNIGHT DICKENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 221-8411
Mailing address
2452 CHURCHILL DR, BOSSIER CITY, LA 71111-5558
(318) 464-9656
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14173
LA
Other
Enumeration date
08/14/2006
Last updated
07/08/2007
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