Individual
KACIE DORE' KEITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1541 KINGS HWY FL 10POST, SHREVEPORT, LA 71103-4228
(318) 678-6881
Mailing address
1541 KINGS HWY FL 10POST, SHREVEPORT, LA 71103-4228
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PST.020248
LA
Other
Enumeration date
01/29/2014
Last updated
12/15/2023
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