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1023390168
RICHARD P FREDERICKSON02/
MANDEVILLE, LA
NPI
1023390168
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
183500000X Pharmacist
(Licence: LA 11041)
Enumeration Date
2011-09-14
Last Update Date
2011-09-14
Business Address
-- RICHARD P FREDERICKSON02/
4540 HIGHWAY 22
MANDEVILLE, LA 70471-3300
Phone number: 985-674-3320
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Mailing Address
-- RICHARD P FREDERICKSON02/
4540 HIGHWAY 22
MANDEVILLE, LA 70471-3300
Phone number: 985-674-3320
Copy
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