Individual
MR. IVAN ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.D.
Contact information
Practice address
7139 U S HWY 61, SAINT FRANCISVILLE, LA 70775-7139
(225) 635-3885
(225) 635-0290
Mailing address
PO BOX 2668, SAINT FRANCISVILLE, LA 70775-2668
(225) 635-3885
(225) 635-0290
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PST.016241
LA
Other
Enumeration date
10/31/2012
Last updated
10/31/2012
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