Individual
INDYA BRUCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14360 WAX RD, BATON ROUGE, LA 70818-4279
(225) 261-6541
Mailing address
10201 PARK ROWE AVE APT 2319, BATON ROUGE, LA 70810-2295
(504) 338-0589
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
023127
LA
Other
Enumeration date
09/03/2019
Last updated
09/03/2019
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