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Individual

NATASHA PHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3400 AIRLINE DR, BOSSIER CITY, LA 71111-2122
(318) 741-6589
Mailing address
300 BAYOU TRACE DR, MONROE, LA 71203-6121

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PST.023589
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PST.023589
PHARMACIST LICENSE
LA
Enumeration date
10/07/2020
Last updated
10/07/2020
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