Individual
MR. JEFFERY SCOTT MULLICAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
916 N PINE ST, DERIDDER, LA 70634-2816
(337) 462-2019
Mailing address
916 N PINE ST, DE RIDDER, LA 70634-2816
(337) 462-2019
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
13608
LA
Other
Enumeration date
09/03/2010
Last updated
09/03/2010
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