Individual
ELIZABETH GULTOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
324 MASSACHUSETTS AVE, ARLINGTON, MA 02474-8392
(781) 643-4112
Mailing address
15 SAINT MARY ST, MEDFORD, MA 02155-2827
(617) 676-8930
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH240591
MA
Other
Enumeration date
04/20/2022
Last updated
04/21/2022
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