Individual
BRIAN FONTAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D
Contact information
Practice address
271 MAMMOTH RD, MANCHESTER, NH 03109-4124
(603) 623-3995
Mailing address
88 PATRICIA LN, MANCHESTER, NH 03104-2865
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
4178
NH
Other
Enumeration date
08/30/2017
Last updated
08/30/2017
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