Please tell us if you have a preferred Pharmacy, their location and their phone number.
the patient been treated for any of the following? (check
yes or no)
Alan B. Richards, M.D. • John D. Hinrichsen, M.D. • Amy E. Coburn, O.D.
1400 East Bert KounsShreveport, LA 71105(318) 222-84021-800-437-0153
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