Individual
DR. ANTWON BOSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1585 3RD ST BLDG 285, FORT POLK, LA 71459-5102
(337) 531-8090
Mailing address
5965 HARRELL ST APT B, FORT POLK, LA 71459-3698
(707) 898-0182
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
PHCY-04573
NH
Other
Enumeration date
12/18/2020
Last updated
12/18/2020
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