Individual
INSIK AN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4460 LAKE ST, LAKE CHARLES, LA 70605-4312
(337) 478-9825
Mailing address
4460 LAKE ST, LAKE CHARLES, LA 70605-4312
(337) 478-9825
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PST.020867
LA
Other
Enumeration date
12/01/2014
Last updated
12/16/2014
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