Individual
PAUL TIMOTHY LUONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1585 3RD ST, FORT POLK, LA 71459-5102
(941) 284-8984
Mailing address
5345 TANKERSLEY CT APT C, FORT POLK, LA 71459-3669
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PS56479
FL
Other
Enumeration date
12/17/2018
Last updated
12/17/2018
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