Individual
KATHERINE JACOB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
10 GENE DR, SHELTON, CT 06484-5733
(203) 927-6369
Mailing address
10 GENE DR, SHELTON, CT 06484-5733
(203) 927-6369
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PCT.0012428
CT
Other
Enumeration date
08/22/2012
Last updated
08/22/2012
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