Individual
LEO ENNIS FLENIKEN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PD
Contact information
Practice address
3045 E TEXAS ST, BOSSIER CITY, LA 71111-3207
(318) 741-1776
Mailing address
529 STRATMORE DR, SHREVEPORT, LA 71115-3019
(318) 455-8255
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9549
LA
Other
Enumeration date
04/15/2015
Last updated
04/15/2015
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