Individual
THO LE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
755 SHERWOOD FOREST BLVD, BATON ROUGE, LA 70815-5261
(225) 603-7677
Mailing address
755 SHERWOOD FOREST BLVD, BATON ROUGE, LA 70815-5261
(225) 603-7677
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PST.024475
LA
390200000X
Student in an Organized Health Care Education/Training Program
S12706
AL
Other
Enumeration date
01/23/2020
Last updated
09/18/2022
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