Individual
GLENN FORTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
35 COLUMBIA RD, HANOVER, MA 02339-2317
(781) 499-4003
(781) 499-4006
Mailing address
12 FOSTER AVE, MARSHFIELD, MA 02050-3813
(781) 499-4003
(781) 499-4006
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
21965
MA
Other
Enumeration date
10/26/2007
Last updated
10/26/2007
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