Individual
BENTON WAYNE LOVELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4306 S GRAND ST, MONROE, LA 71202-6322
(318) 418-3745
Mailing address
8326 KELWOOD AVE, BATON ROUGE, LA 70806-4803
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
01/18/2020
Last updated
01/28/2020
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