Individual
JEFFREY TODD LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
123 SAINT NAZAIRE RD, BROUSSARD, LA 70518-4202
(337) 837-8131
(337) 837-8033
Mailing address
123 SAINT NAZAIRE RD, BROUSSARD, LA 70518-4202
(337) 837-8131
(337) 837-8033
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
13553
LA
Other
Enumeration date
08/12/2014
Last updated
08/12/2014
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