Individual
JAKE A BOURQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
621 W MAPLE AVE, EUNICE, LA 70535-5300
(337) 546-6386
Mailing address
621 W MAPLE AVE, EUNICE, LA 70535-5300
(337) 546-6386
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PST.020714
LA
Other
Enumeration date
08/18/2014
Last updated
11/19/2015
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