Individual
ED THOMASON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2850 VALKYRIE DR, BOSSIER CITY, LA 71111-2094
(318) 676-9181
Mailing address
2850 VALKYRIE DR, BOSSIER CITY, LA 71111-2094
(318) 676-9181
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11084
LA
Other
Enumeration date
11/04/2013
Last updated
11/04/2013
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