Tina Detillier

NPI #1174651335 in Raceland, Louisiana

Provider Information

NPI Number: 1174651335
Entity Type: Individual
Name: Tina Detillier
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pharmacist
Enumeration Date: Mar 1, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 108 ACADIA DR
City: Raceland
State: Louisiana
ZIP Code: 70394-0108
Phone: (985) 537-5255

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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