Individual
TRACEY DONOVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
80 CLARK DR, EAST BERLIN, CT 06023-1157
(888) 319-1818
Mailing address
80 CLARK DR, EAST BERLIN, CT 06023-1157
(888) 319-1818
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
8472
CT
Other
Enumeration date
10/18/2016
Last updated
10/18/2016
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