Individual
MR. JOHN JOSEPH REVERE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
525 KNOTTER DR, CHESHIRE, CT 06410-1100
(800) 895-8427
(800) 896-8427
Mailing address
525 KNOTTER DR, CHESHIRE, CT 06410-1100
(800) 895-8427
(800) 896-8427
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PCT.0008686
CT
Other
Enumeration date
02/18/2010
Last updated
02/18/2010
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