Individual
BRYAN JEANSONNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
521 ASBURY DRIVE, MANDEVILLE, LA 70471
(985) 264-0512
Mailing address
626 VILLAGE LN S APT B, MANDEVILLE, LA 70471-2988
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
18366
LA
Other
Enumeration date
08/11/2010
Last updated
02/26/2018
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