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1235561804
JOHN DAVID CLELLAND
GROTON, CT
NPI
1235561804
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date
2013-08-06
Last Update Date
2013-08-06
Business Address
-- JOHN DAVID CLELLAND SUB IDC
1 WAHOO AVE
GROTON, CT 06349-2324
Phone number: 330-573-1202
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Mailing Address
-- JOHN DAVID CLELLAND SUB IDC
168 ARROWOOD DR
GROTON, CT 06340-2509
Phone number: 330-573-1202
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