Individual
REBECCA BROCK PRUDHOMME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
6130 JOHNSTON ST, LAFAYETTE, LA 70503-5619
(225) 206-2533
Mailing address
6130 JOHNSTON ST, LAFAYETTE, LA 70503-5619
(225) 206-2533
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
021060
LA
Other
Enumeration date
03/02/2017
Last updated
03/02/2017
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