Individual
JOHN ALEXANDER MIMOSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
786 ASHLEY BLVD, NEW BEDFORD, MA 02745-5548
(508) 998-3831
Mailing address
786 ASHLEY BLVD, NEW BEDFORD, MA 02745-5548
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH238988
MA
Other
Enumeration date
11/30/2020
Last updated
11/30/2020
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