Individual
RUSSELL ROARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
5251 CYPRESS STREET, WEST MONROE, LA 71291
(318) 267-3505
Mailing address
5251 CYPRESS STREET, WEST MONROE, LA 71291
(318) 267-3505
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15706
LA
Other
Enumeration date
06/12/2014
Last updated
07/22/2016
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