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1932750411
JAE WAGGONER
BOSSIER CITY, LA
NPI
1932750411
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
183500000X Pharmacist
(Licence: LA PST.023190)
Enumeration Date
2019-09-25
Last Update Date
2023-04-19
Business Address
Dr. JAE WAGGONER PharmD
2107 AIRLINE DR
BOSSIER CITY, LA 71111-3105
Phone number: 318-742-5590
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Mailing Address
Dr. JAE WAGGONER PharmD
320 PRESERVE BLVD
BOSSIER CITY, LA 71112-2081
Phone number:
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