Individual
MITCHELL TELLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
9194 MANSFIELD RD, SHREVEPORT, LA 71118-3123
(318) 687-7272
Mailing address
3257 BERT KOUNS INDUSTRIAL LOOP APT 11106, SHREVEPORT, LA 71118-2964
(512) 565-2256
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
024398
LA
Other
Enumeration date
07/25/2022
Last updated
07/25/2022
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