Individual
VISAL SOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
241 MIDDLE TPKE W, MANCHESTER, CT 06040-3834
(860) 533-1156
Mailing address
241 MIDDLE TPKE W, MANCHESTER, CT 06040-3834
(860) 533-1156
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0010377
CT
Other
Enumeration date
04/19/2016
Last updated
04/19/2016
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