Most Relevant Information
Provider Data
| NPI Number: | 1003437591 |
| Provider Name: | WACEY TAYLOR |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | 023385 |
Most Important Dates
| Enumeration Date: | 05/06/2020 |
| Last Updated: | 05/06/2020 |
Provider Practice Location
7004 YOUREE DR
SHREVEPORT
LA
711055109
Practice Location Phone/Fax
| Phone: | 3187973665 |
| Fax: |
Provider Mailing Location
7004 YOUREE DR
SHREVEPORT
LA
711055109
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |