Individual
MICHELLE ELLOIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2104 WILLIAMS BLVD, KENNER, LA 70062-5806
(504) 469-0976
Mailing address
PO BOX 2077, KENNER, LA 70063-2077
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14861
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14861
PHARMACY
LA
Enumeration date
03/28/2007
Last updated
07/08/2007
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