Individual
MARK MOUTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3005 CHARITY ST, ABBEVILLE, LA 70510-4140
(337) 893-4077
(337) 893-4079
Mailing address
3005 CHARITY ST, ABBEVILLE, LA 70510-4140
(337) 893-4077
(337) 893-4079
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10138
LA
Other
Enumeration date
08/15/2014
Last updated
08/15/2014
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