Provider Demographics
NPI:1730497132
Name:LEBLANC, TONYA (RPH)
Entity Type:Individual
Prefix:MS
First Name:TONYA
Middle Name:
Last Name:LEBLANC
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 MILITARY HWY
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71360
Mailing Address - Country:US
Mailing Address - Phone:318-640-8066
Mailing Address - Fax:318-640-5295
Practice Address - Street 1:3400 MILITARY HIGHWAY
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:LA
Practice Address - Zip Code:71360-4109
Practice Address - Country:US
Practice Address - Phone:318-640-8066
Practice Address - Fax:318-640-5295
Is Sole Proprietor?:No
Enumeration Date:2010-09-20
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA015323183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist