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1679034011
DEREK JAMES HALE
GROTON, CT
NPI
1679034011
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date
2019-03-28
Last Update Date
2019-03-28
Business Address
DEREK JAMES HALE
FC 83 NUMI TROUT AVE
GROTON, CT 06340
Phone number: 860-694-2876
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Mailing Address
DEREK JAMES HALE
445 BURNINGTREE DR
GROTON, CT 06340-3109
Phone number: 361-522-7382
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