Individual
MRS. DIANE C GRIBBIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
1271 MAIN ST, WATERTOWN, CT 06795-3107
(860) 274-9191
Mailing address
109 NORTHWEST DR, WATERTOWN, CT 06795-2044
(860) 274-9756
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
7624
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7624
PHARMACY LICENSE
CT
Enumeration date
05/11/2011
Last updated
05/11/2011
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