Individual
RAVEN ALEXANDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2204 S 5TH ST, LEESVILLE, LA 71446-5318
(337) 238-9041
Mailing address
4818 WESTGARDEN BLVD, ALEXANDRIA, LA 71303-2639
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PST.023977
LA
Other
Enumeration date
08/21/2021
Last updated
08/21/2021
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