Lattana Tina Kettavong, PHARMD

NPI #1245998996 in Clinton, Connecticut

Provider Information

NPI Number: 1245998996
Entity Type: Individual
Name: Lattana Tina Kettavong, PHARMD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pharmacist
Credential: PHARMD
Enumeration Date: Nov 30, 2021
Last Updated: Nov 30, 2021

Practice Location

Address: 218 E MAIN ST
City: Clinton
State: Connecticut
ZIP Code: 06413-2230
Phone: (860) 664-4641

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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