Individual
MR. BLANE EDWIN PERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1780 S 5TH ST, LEESVILLE, LA 71446-5306
(337) 239-4249
Mailing address
585 HERMAN SMITH RD, DERIDDER, LA 70634-4442
(337) 463-6823
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11249
LA
1835P1200X
Pharmacotherapy Pharmacist
11249
LA
Other
Enumeration date
07/06/2009
Last updated
07/06/2009
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