Individual
MRS. JESSICA LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PD
Contact information
Practice address
2564 BARATARIA BLVD, MARRERO, LA 70072-5304
(504) 340-3592
(504) 340-3617
Mailing address
2564 BARATARIA BLVD, MARRERO, LA 70072-5304
(504) 340-3592
(504) 340-3617
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
020187
LA
Other
Enumeration date
10/14/2014
Last updated
10/14/2014
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