PAUL ROLAND PROVOST

LAFAYETTE, LA
NPI1609158534
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy183500000X Pharmacist
(Licence: LA  14331)
Enumeration Date2011-09-16
Last Update Date2011-09-16
Business Address
Mr. PAUL ROLAND PROVOST rph
804 ROBERT LEE CIR
LAFAYETTE, LA 70506-3143
Phone number: 337-654-9777
Mailing Address
Mr. PAUL ROLAND PROVOST rph
804 ROBERT LEE CIR
LAFAYETTE, LA 70506-3143
Phone number: 337-654-9777
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