Individual
ANDREW THEVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
111 WESTGATE RD, LAFAYETTE, LA 70506-2710
(337) 232-5506
Mailing address
1371 THEVIS RD, EUNICE, LA 70535-7509
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
021697
LA
Other
Enumeration date
08/31/2016
Last updated
08/31/2016
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