Individual
IBTISAM MAHROUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5349 CYPRESS ST, WEST MONROE, LA 71291-7505
(318) 397-8152
Mailing address
521 SHADY LN, MONROE, LA 71203-2236
(318) 351-6655
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
023498
LA
Other
Enumeration date
08/19/2020
Last updated
08/19/2020
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