Mason Boutwell
Mason Boutwell is a Student in an Organized Health Care Education/Training Program in Jackson, Mississippi. Practices as a sole proprietor. Registered with an NPI since 2024.
- In the registry since
- 2024
Practice location Address checks out
2500 N State StJackson, MS 39216-4500
Phone: (601) 270-3312
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Specialties & licences
| Student in an Organized Health Care Education/Training Program (primary) | Taxonomy 390200000X |
|---|
Record details
| NPI number | 1114753597 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | September 11, 2024 |
| Last updated in NPPES | September 11, 2024 |
| Certification date | September 11, 2024 |
| Mailing address | 2500 N State St, Jackson, MS 39216-4500 |
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