Individual
MARK STEVEN NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 221-8411
(318) 424-6002
Mailing address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 221-8411
(318) 424-6002
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11798
LA
Other
Enumeration date
08/01/2006
Last updated
07/08/2007
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