Individual
JEANNELLE FONTENOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17682 AIRLINE HWY, PRAIRIEVILLE, LA 70769-3304
(225) 677-9501
Mailing address
40320 PELICAN POINT PKWY, GONZALES, LA 70737-8510
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
16567
LA
Other
Enumeration date
03/15/2007
Last updated
03/02/2022
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