Individual
JEANNE BOURQUE MAYLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1635 HIGHWAY 3125, GRAMERCY, LA 70052
(225) 869-3651
(225) 869-8826
Mailing address
PO BOX 1511, GRAMERCY, LA 70052-1511
(225) 869-3651
(225) 869-8826
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
16714
LA
Other
Enumeration date
03/05/2007
Last updated
08/18/2011
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