Individual
MR. AUBREY BOOTH WYNN III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH MBA MHA
Contact information
Practice address
9250 MANSFIELD RD, SHREVEPORT, LA 71118-3125
(318) 686-6311
(318) 686-3999
Mailing address
9250 MANSFIELD RD, SHREVEPORT, LA 71118-3125
(318) 686-6311
(318) 686-3999
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14260
LA
Other
Enumeration date
02/04/2013
Last updated
02/04/2013
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