Individual
CHARLES BLAINE FONTENOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
3384 GOVERNMENT ST, BATON ROUGE, LA 70806-5628
(225) 387-5600
Mailing address
3384 GOVERNMENT ST, BATON ROUGE, LA 70806-5628
(225) 387-5600
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14054
LA
Other
Enumeration date
09/29/2011
Last updated
09/29/2011
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