ROLAND S. WAGUESPACK MD
1108 Saint James St
Vacherie, LA 70090
225-265-4087
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 3336C0002X | Suppliers - Pharmacy - Clinic Pharmacy | LA | 009974 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
1442224 | LA | MEDICAID |