Individual
KIMBERLY TETRAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 FOREST GLEN RD, SILVER SPRING, MD 20910-1483
(301) 754-7126
(301) 754-7127
Mailing address
5480 WISCONSIN AVE APT 916, CHEVY CHASE, MD 20815-3513
(765) 748-1213
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17763
MD
Other
Enumeration date
05/17/2007
Last updated
07/08/2007
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