Individual
KAREN A WIDAMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
105 SOUTHFIELD RD, SHREVEPORT, LA 71105-3702
(318) 861-2431
(318) 861-4445
Mailing address
105 SOUTHFIELD RD, SHREVEPORT, LA 71105-3702
(318) 861-2431
(318) 861-4445
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15851
LA
Other
Enumeration date
10/10/2012
Last updated
10/10/2012
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