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1013430016
IVAN LEAVITT BROWN
GROTON, CT
NPI
1013430016
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date
2017-07-21
Last Update Date
2017-07-21
Business Address
IVAN LEAVITT BROWN
159 TROUT AVENUE SUBASE NEW LONDON
GROTON, CT 06340
Phone number: 847-254-3904
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Mailing Address
IVAN LEAVITT BROWN
235 CHARTER OAK DR
GROTON, CT 06340-2934
Phone number: 847-254-3904
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