Individual
JENNY BLACKBURN TREE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.PH.
Contact information
Practice address
3000 N MARKET ST, SHREVEPORT, LA 71107-4062
(318) 424-3251
Mailing address
3000 N MARKET ST, SHREVEPORT, LA 71107-4062
(318) 424-3251
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
16375
LA
Other
Enumeration date
09/08/2010
Last updated
09/08/2010
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