Individual
THANH JOHNNY LE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1305 GAUSE BLVD, SLIDELL, LA 70458-3015
(985) 641-2550
Mailing address
1305 GAUSE BLVD, SLIDELL, LA 70458-3015
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
08/18/2020
Last updated
08/18/2020
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