Individual
MR. LEROY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
4097 RYAN ST, LAKE CHARLES, LA 70605-2819
(337) 474-0434
(337) 474-2778
Mailing address
4097 RYAN ST, LAKE CHARLES, LA 70605-2819
(337) 474-0434
(337) 474-2778
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11421
LA
Other
Enumeration date
08/15/2010
Last updated
08/15/2010
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