Individual
BILLY COTHRAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
109 AVENUE A, JONESBORO, LA 71251-3507
(318) 395-2094
Mailing address
109 AVENUE A, JONESBORO, LA 71251-3507
(318) 395-2094
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
8033956
LA
Other
Enumeration date
11/27/2018
Last updated
11/27/2018
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