Individual
MR. GANNON G BROUILLETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1406 W LANDRY ST, OPELOUSAS, LA 70570-2623
(337) 942-2653
(337) 942-8490
Mailing address
1406 W LANDRY ST, OPELOUSAS, LA 70570-2623
(337) 344-6004
(337) 942-8490
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
16118
LA
Other
Enumeration date
03/15/2007
Last updated
08/22/2023
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