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Individual

BRIAN SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2205 21ST ST, KENNER, LA 70062-5807
(504) 469-2596
(504) 831-3272
Mailing address
2205 21ST ST, KENNER, LA 70062-5807
(504) 469-2596
(504) 831-3272

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10386
LA

Other

Enumeration date
08/31/2006
Last updated
07/08/2007
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