Individual
PHILIP PAUL MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 221-8411
Mailing address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
22805
LA
Other
Enumeration date
04/08/2019
Last updated
04/08/2019
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