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1518743178
TAVARES CAMPBELL
SOUTHINGTON, CT
NPI
1518743178
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
376J00000X Homemaker
(Licence: CT 0002272)
Enumeration Date
2023-09-07
Last Update Date
2023-09-07
Business Address
TAVARES CAMPBELL
89 ROCHELA DR
SOUTHINGTON, CT 06489-4670
Phone number: 860-781-1973
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Mailing Address
TAVARES CAMPBELL
89 ROCHELA DR
SOUTHINGTON, CT 06489-4670
Phone number: 860-781-1973
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