Individual
KITIYA JUEAWATTANASIRIKUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
19 DODGE ST, BEVERLY, MA 01915-1705
(978) 927-0060
Mailing address
19 DODGE ST, BEVERLY, MA 01915-1705
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH238602
MA
Other
Enumeration date
11/19/2020
Last updated
11/19/2020
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