Individual
GARY MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
242 W SHAMROCK ST, BUILDING 1, PINEVILLE, LA 71360
(318) 484-6234
(318) 484-6881
Mailing address
PO BOX 112, GLENMORA, LA 71433-0112
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15028
LA
Other
Enumeration date
03/09/2007
Last updated
07/08/2007
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