Individual
BRIAN SONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
54 ELLIOTT ST, BEVERLY, MA 01915-3359
(978) 921-0506
Mailing address
341 SECOND AVE APT 356, WALTHAM, MA 02451-1227
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH997184
MA
Other
Enumeration date
10/23/2023
Last updated
10/23/2023
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