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1578854410
DWAYNE PAUL BOURGEOIS
BATON ROUGE, LA
NPI
1578854410
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
183500000X Pharmacist
(Licence: LA 15407)
Enumeration Date
2011-04-26
Last Update Date
2011-04-26
Business Address
-- DWAYNE PAUL BOURGEOIS
2159 STARING LN
BATON ROUGE, LA 70810-1038
Phone number: 225-766-1107
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Mailing Address
-- DWAYNE PAUL BOURGEOIS
14231 SANTA FE TRL
PRAIRIEVILLE, LA 70769-4456
Phone number: 225-677-6999
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