Individual
MR. CARL VONBODUNGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11179 HIGHWAY 49, GULFPORT, MS 39503
(228) 832-6280
Mailing address
3609 LAKE PROVIDENCE DR, HARVEY, LA 70058
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
T-010311
MS
Other
Enumeration date
04/19/2011
Last updated
04/19/2011
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