Individual
PHILIP ALLEN MEDARIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6280 HIGHWAY 3, BENTON, LA 71006-3492
(318) 965-3669
Mailing address
613 PLACID PT, BOSSIER CITY, LA 71111-8403
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15514
LA
Other
Enumeration date
05/08/2012
Last updated
05/08/2012
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