Individual
MR. GARTH RAYMOND RETALLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
346 ELLIOTT ST, BEVERLY, MA 01915-2347
(978) 697-2744
Mailing address
346 ELLIOTT ST, BEVERLY, MA 01915-2347
(978) 697-2744
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/21/2013
Last updated
02/21/2013
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