Individual
BRANDON CORLISS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM.D
Contact information
Practice address
9550 MANSFIELD RD, SHREVEPORT, LA 71118-4402
(318) 688-4151
(318) 688-5610
Mailing address
9550 MANSFIELD RD, SHREVEPORT, LA 71118-4402
(318) 688-4151
(318) 688-5610
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17718
LA
Other
Enumeration date
04/04/2014
Last updated
04/04/2014
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