| NPI | 1649256058 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS Y KALSTONE Compounding Pharmacist 318-222-0885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: LA 10973) |
| Enumeration Date | 2005-12-16 |
| Last Update Date | 2020-08-22 |