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Individual

TAMARA PRINCE BREAUX

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHARMD

Contact information

Practice address
2825 RYAN ST, LAKE CHARLES, LA 70601-7329
(337) 434-1590
(337) 437-7639
Mailing address
3895 HOBBINS RD, VINTON, LA 70668-5407
(337) 660-1542

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
018203
LA

Other

Enumeration date
04/07/2011
Last updated
04/07/2011
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