Individual
MR. BRIAN DAVID FONTAINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
125 MASCOMA ST, LEBANON, NH 03766-2647
(603) 448-7404
Mailing address
23 GRANDVIEW AVE, LEBANON, NH 03766-1870
(603) 448-9701
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
R1081
NH
Other
Enumeration date
05/09/2007
Last updated
07/08/2007
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