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1346092160
BALDEMAR VILLARREAL
GROTON, CT
NPI
1346092160
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date
2024-04-04
Last Update Date
2024-04-04
Business Address
BALDEMAR VILLARREAL IDC
BLDG 159 TROUT AVE
GROTON, CT 06340
Phone number: 210-815-0930
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Mailing Address
BALDEMAR VILLARREAL IDC
60 ARROWOOD DR
GROTON, CT 06340-2544
Phone number: 210-815-0930
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