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1154941631
JONATHAN BLAINE LOPEZ
LAKE CHARLES, LA
NPI
1154941631
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
183500000X Pharmacist
(Licence: LA .017781)
Enumeration Date
2020-04-24
Last Update Date
2023-11-27
Business Address
JONATHAN BLAINE LOPEZ
1725 W SALE RD
LAKE CHARLES, LA 70605-2521
Phone number: 337-474-7001
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Mailing Address
JONATHAN BLAINE LOPEZ
1725 W SALE RD
LAKE CHARLES, LA 70605-2521
Phone number: 337-474-7001
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