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Individual

LOC DO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
246 BROADWAY UNIT 2, METHUEN, MA 01844-3044
(978) 258-5828
Mailing address
246 BROADWAY UNIT 2, METHUEN, MA 01844-3044
(978) 258-5828

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
4268
NH
183500000X
Pharmacist
PH238830
MA

Other

Enumeration date
11/02/2016
Last updated
02/12/2020
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