Individual
MICHAEL RAND PETTIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
114 GLORIA DR, LAKE CHARLES, LA 70611
(337) 314-9559
Mailing address
114 GLORIA DR, LAKE CHARLES, LA 70611
(337) 314-9559
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17789
LA
Other
Enumeration date
08/16/2010
Last updated
04/16/2020
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