Individual
MRS. BRENDA THOMAS LEGAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3124 LINE AVE, SHREVEPORT, LA 71104-4240
(318) 222-4807
(318) 222-6995
Mailing address
3124 LINE AVE, SHREVEPORT, LA 71104-4240
(318) 222-4807
(318) 222-6995
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15289
LA
Other
Enumeration date
09/09/2011
Last updated
09/09/2011
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