Individual
CHRISTIAN KIRK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
105 W HIGHWAY 30, GONZALES, LA 70737-4802
(225) 644-0434
Mailing address
8104 ANTEBELLUM AVE, BATON ROUGE, LA 70820-5303
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PST.024494
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PST.024494
BOARD OF PHARMACY
LA
Enumeration date
09/20/2022
Last updated
09/20/2022
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