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1184250722
WALTER M JONGBLOED
FARMINGTON, CT
NPI
1184250722
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2020-03-16
Last Update Date
2020-03-16
Business Address
WALTER M JONGBLOED
263 FARMINGTON AVE
FARMINGTON, CT 06030-0001
Phone number: 203-868-4157
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Mailing Address
WALTER M JONGBLOED
236 FARMINGTON AVE
FARMINGTON, CT 06030-0001
Phone number: 203-868-4157
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