NPI 1104437813

Mallory Anne Ketcham, PHARMD

Practitioner Pharmacist Brandon, VT

Practice location

Address: 1 Union St, Brandon, VT 05733-1127
Phone: (802) 247-8050
Fax: (802) 247-4237

Registered specialties

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence 033.0134411 (VT)

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Registry record

NPI: 1104437813
Entity type: Individual
Sex (as registered): Female
NPI issued: 14 Aug 2020
Record last updated: 19 Dec 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.