NPI 1295321669

Antwon Boston, PHARMD

Practitioner Military Health Care Provider Fort Polk, LA

Practice location

Address: 1585 3rd St Bldg 285, Fort Polk, LA 71459-5102
Phone: (337) 531-8090
Mailing address: 5965 Harrell St APT B, Fort Polk, LA 71459-3698

Registered specialties

Military Health Care Provider Primary

Other Service Providers Taxonomy 171000000X Licence PHCY-04573 (NH)

Other Military Health Care Provider providers in Louisiana →

Registry record

NPI: 1295321669
Entity type: Individual
Sex (as registered): Male
NPI issued: 18 Dec 2020
Record last updated: 18 Dec 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.