Individual
WALTER JOSEPH DOUGLASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
221 MAIN STREET, DURHAM, CT 06422-1614
(860) 349-3478
(860) 349-1240
Mailing address
221 MAIN STREET, DURHAM, CT 06422-1614
(860) 349-3478
(860) 349-1240
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5372
CT
Other
Enumeration date
12/30/2020
Last updated
12/30/2020
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