Individual
REGINALD BOUTTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
806 JEFFERSON TER, NEW IBERIA, LA 70560-5727
(337) 376-6868
(337) 376-6866
Mailing address
806 JEFFERSON TER, NEW IBERIA, LA 70560-5727
(337) 376-6868
(337) 376-6866
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PST.016411
LA
Other
Enumeration date
06/27/2019
Last updated
06/27/2019
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