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Individual

ASHLEY V MUTHERSBAUGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHARMD. RPH

Contact information

Practice address
508 MONROE TPKE, MONROE, CT 06468-2309
(203) 268-6315
Mailing address
508 MONROE TPKE, MONROE, CT 06468-2309

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
0014269
CT
183500000X
Pharmacist
Primary
PCT.0014269
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0014269
PHARMACIST
CT
Enumeration date
01/30/2018
Last updated
01/30/2018
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