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1053687715
JENNA RUSSELL DALLINGA
DANBURY, CT
NPI
1053687715
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
174400000X Specialist
(Licence: CT 005456)
Enumeration Date
2012-03-27
Last Update Date
2012-03-27
Business Address
Ms. JENNA RUSSELL DALLINGA LMT
40 LAKE AVENUE EXT
DANBURY, CT 06811-5283
Phone number: 845-612-9849
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Mailing Address
Ms. JENNA RUSSELL DALLINGA LMT
103 HARVEST DR
BREWSTER, NY 10509-3706
Phone number: 845-612-9849
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