Individual
KYLA G FULCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM D
Contact information
Practice address
5711 YOUREE DR, SHREVEPORT, LA 71105-4216
(318) 868-3621
(318) 866-2646
Mailing address
5711 YOUREE DR, SHREVEPORT, LA 71105-4216
(318) 868-3621
(318) 866-2646
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
018218
LA
Other
Enumeration date
03/14/2011
Last updated
03/14/2011
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