Individual
MR. LAWRENCE JACKSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
3700 DEVEREAUX CT, AVONDALE, LA 70094-2589
(504) 644-4975
Mailing address
3700 DEVEREAUX CT, AVONDALE, LA 70094-2589
(504) 644-4975
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14930
LA
Other
Enumeration date
05/04/2009
Last updated
05/04/2009
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