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1104427590
JAMES WESLEY SOUTHERN
SHREVEPORT, LA
NPI
1104427590
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
183500000X Pharmacist
(Licence: LA 016772)
Enumeration Date
2020-11-03
Last Update Date
2020-11-03
Business Address
JAMES WESLEY SOUTHERN
7400 YOUREE DR
SHREVEPORT, LA 71105-5536
Phone number: 318-798-0566
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Mailing Address
JAMES WESLEY SOUTHERN
158 LORE DRIVE
STONEWALL, LA 71078
Phone number: 318-210-7258
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