Individual
KELLY HACKWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
606 HOMER ROAD, MINDEN, LA 71055
(318) 377-0131
(318) 377-5681
Mailing address
606 HOMER ROAD, MINDEN, LA 71055
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17489
LA
Other
Enumeration date
10/12/2011
Last updated
10/12/2011
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