Individual
FUNMILAYO YESUFU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1100 W PINE ST, PONCHATOULA, LA 70454-3700
(985) 386-2421
Mailing address
109 NEW CAMELLIA BLVD STE 106, COVINGTON, LA 70433-7829
(985) 792-3521
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
025037
LA
Other
Enumeration date
10/27/2023
Last updated
10/27/2023
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