Provider Demographics
NPI:1548485766
Name:DOMITROVICH, FRANCIS JOHN II (PHARMD)
Entity type:Individual
Prefix:DR
First Name:FRANCIS
Middle Name:JOHN
Last Name:DOMITROVICH
Suffix:II
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 ASH BROOK RD
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-5918
Mailing Address - Country:US
Mailing Address - Phone:603-852-6440
Mailing Address - Fax:
Practice Address - Street 1:46 ASH BROOK RD
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-5918
Practice Address - Country:US
Practice Address - Phone:603-852-6440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-14
Last Update Date:2007-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3434183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist