Individual
GRACE PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2005 NORWICH NEW LONDON TPKE, UNCASVILLE, CT 06382-1369
(860) 848-3202
Mailing address
87 STRAWBERRY ST, LISBON, CT 06351-2837
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PCT.14114
CT
Other
Enumeration date
03/13/2019
Last updated
03/13/2019
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