Individual
CHAIYAPRUK PHANTUMVANIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD.
Contact information
Practice address
450 BROOKLINE AVE, BOSTON, MA 02215-5450
(617) 632-4454
Mailing address
450 BROOKLINE AVE, BOSTON, MA 02215-5450
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH26893
MA
Other
Enumeration date
08/10/2020
Last updated
08/10/2020
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