Individual
WAGIH SOUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4283 CARTER ST., VIDALIA, LA 71373
(318) 336-8801
Mailing address
4283 CARTER ST, VIDALIA, LA 71373-3148
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
015726
LA
Other
Enumeration date
12/03/2015
Last updated
12/03/2015
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