MICHAEL M PROVOST

WEST MONROE, LA
NPI1669755302
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy183500000X Pharmacist
(Licence: LA  15527)
Enumeration Date2011-09-20
Last Update Date2011-09-20
Business Address
-- MICHAEL M PROVOST RPh
755 OLE HIGHWAY 15 LOT 92
WEST MONROE, LA 71291-1413
Phone number: 318-680-3590
Mailing Address
-- MICHAEL M PROVOST RPh
755 OLE HIGHWAY 15 LOT 92
WEST MONROE, LA 71291-1413
Phone number: 318-680-3590
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