Individual
CHARLES E MASON III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
3225 LOUISIANA AVE, T-2377, LAFAYETTE, LA 70501-1406
(337) 769-7516
Mailing address
3225 LOUISIANA AVE, T-2377, LAFAYETTE, LA 70501-1406
(337) 769-7516
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
019623
LA
Other
Enumeration date
10/06/2011
Last updated
10/06/2011
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