Individual
JORDAN RAYCE DALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM. D.
Contact information
Practice address
2799 W THOMAS ST, HAMMOND, LA 70401-2838
(985) 542-5582
Mailing address
2799 W THOMAS ST, HAMMOND, LA 70401-2838
(985) 542-5582
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PST.020604
LA
Other
Enumeration date
06/27/2014
Last updated
01/01/2021
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