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Individual

CLAY LAWRENCE BOLDUC

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARMD, RPH

Contact information

Practice address
141 PREBLE ST, PORTLAND, ME 04101-2440
(207) 899-0939
Mailing address
5 MAYBERRY RD APT 3, WINDHAM, ME 04062-4789

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PR69370
ME

Other

Enumeration date
12/02/2020
Last updated
12/02/2020
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