Individual
KATIE ROSE MATTOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
193 BOSTON POST RD, OLD LYME, CT 06371-1312
(860) 510-6975
Mailing address
193 BOSTON POST RD, OLD LYME, CT 06371-1312
(860) 510-6975
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PCT.0010968
CT
Other
Enumeration date
02/20/2021
Last updated
02/20/2021
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