Individual
MRS. KHANH MAI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1624 N BURNSIDE AVE, GONZALES, LA 70737-2139
(225) 644-7528
Mailing address
4710 OLD OAK DR, ORANGE, TX 77632-1320
(409) 338-2893
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
018877
LA
Other
Enumeration date
08/14/2013
Last updated
08/14/2013
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