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Individual

RICHARD TANYI AGBORTOKO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
616 FOREST AVE, PORTLAND, ME 04101-1510
(207) 761-9454
Mailing address
62 LELAND ST, APARTMENT 1, PORTLAND, ME 04103-2528
(617) 794-0293

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PR12976
ME

Other

Enumeration date
04/28/2014
Last updated
04/28/2014
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