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Individual

MR. KENNETH SCOTT FUSSELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
804 W OAK ST, AMITE, LA 70422-2700
(985) 748-6748
(985) 748-6763
Mailing address
76386 HIGHWAY 51, KENTWOOD, LA 70444-3702
(985) 230-0224
(985) 748-6763

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14343
LA

Other

Enumeration date
08/30/2006
Last updated
07/08/2007
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