Individual
JESSICA SANDOVAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
66 BENTLEY ST, EAST PROVIDENCE, RI 02914-4712
(401) 569-0880
Mailing address
66 BENTLEY ST, EAST PROVIDENCE, RI 02914-4712
(401) 569-0880
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH05625
RI
Other
Enumeration date
08/10/2016
Last updated
08/10/2016
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