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Individual

NEIL A DESAUTELS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
333 MAIN ST, TEWKSBURY, MA 01876-1727
(978) 851-0437
Mailing address
3 APPLE HILL LN, LYNNFIELD, MA 01940-1127
(781) 334-5481

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17542
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
338950
NABP
Enumeration date
04/16/2013
Last updated
04/16/2013
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