Individual
JOHN TEDEROUS SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
800 MAIN ST, SANFORD, ME 04073-3500
(207) 324-3450
Mailing address
69 WELCHS LN, SANFORD, ME 04073-5424
(207) 608-3747
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PR3980
ME
Other
Enumeration date
12/14/2020
Last updated
12/14/2020
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