Individual
JULIE DETERRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1103 KEMPTON ST, NEW BEDFORD, MA 02740-1530
(508) 990-3765
Mailing address
1103 KEMPTON ST, NEW BEDFORD, MA 02740-1530
(508) 990-3765
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
22294
MA
Other
Enumeration date
09/25/2011
Last updated
09/25/2011
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