Individual
DUSTIN BLACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2265 S MACARTHUR DR, ALEXANDRIA, LA 71301-3052
(318) 487-9395
Mailing address
2265 S MACARTHUR DR, ALEXANDRIA, LA 71301-3052
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
047709
LA
Other
Enumeration date
06/18/2018
Last updated
06/18/2018
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