Kelly White Russo RPH

NPI 1770805830 - Pharmacist - 183500000X

NPI Details
NPI 1770805830
Gender Female
Enumeration Date 02/17/2010
Last Updated 02/17/2010
Entity Type Individual
Active Over 6 years ago
Practice Location
510 E STONER AVE
SHREVEPORT LA, 71101-4243, US
Phone (318) 221-8411
Fax
Business Location
4423 CRESWELL AVE
SHREVEPORT LA, 71106-1631, US
Phone
Fax
Toxanomy
Taxonomy Code 183500000X
License State Louisiana
License Number 16746
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According to our database, Kelly White Russo RPH NPI is 1770805830, taxonomy code is 183500000X and license number is 16746, license state is located at Louisiana. Kelly White Russo RPH physically located at 510 E Stoner Ave, Shreveport LA, 71101-4243. NPI Number Kelly White Russo RPH has the Individual type.

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1770805830 NPI number is provided on an as is basis without warranty of any kind. 1770805830 is maintained by the National Plan & Provider Enumeration System. The contents of Kelly White Russo RPH are for informational purposes only.