DWAYNE PAUL BOURGEOIS

BATON ROUGE, LA
NPI1578854410
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy183500000X Pharmacist
(Licence: LA  15407)
Enumeration Date2011-04-26
Last Update Date2011-04-26
Business Address
-- DWAYNE PAUL BOURGEOIS
2159 STARING LN
BATON ROUGE, LA 70810-1038
Phone number: 225-766-1107
Mailing Address
-- DWAYNE PAUL BOURGEOIS
14231 SANTA FE TRL
PRAIRIEVILLE, LA 70769-4456
Phone number: 225-677-6999