Individual
ELIZABETH BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
727 N WASHINGTON ST, BASTROP, LA 71220-3003
(318) 283-5102
(318) 281-3975
Mailing address
727 N WASHINGTON ST, BASTROP, LA 71220-3003
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
1887
LA
Other
Enumeration date
09/28/2012
Last updated
09/28/2012
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