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Individual

TYLER RUTLAND

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
17682 AIRLINE HWY, PRAIRIEVILLE, LA 70769-3304
(225) 677-9501
(225) 677-9503
Mailing address
17475 MCCRORY 1 RD, PRAIRIEVILLE, LA 70769-4631
(225) 673-8714

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
16424
LA

Other

Enumeration date
09/24/2006
Last updated
07/08/2007
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