Individual
MEGAN BOURNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
335 CENTER ST, MANCHESTER, CT 06040-3922
(860) 649-9110
Mailing address
58 BASHAN RD, EAST HADDAM, CT 06423-1222
(908) 310-5983
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0012313
CT
Other
Enumeration date
06/11/2014
Last updated
06/11/2014
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