Individual
MRS. SHANNA TIFFANY SIMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM. D.
Contact information
Practice address
899 N HIGHWAY 171, LAKE CHARLES, LA 70611-5034
(337) 855-4031
(337) 855-4034
Mailing address
5457 CHUCK DR, LAKE CHARLES, LA 70605-5272
(337) 855-4031
(337) 855-4034
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17723
LA
Other
Enumeration date
08/23/2013
Last updated
08/23/2013
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