MARK HALEY JOHNSON

GROTON, CT
NPI1710199666
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date2007-05-04
Last Update Date2011-05-06
Business Address
Mr. MARK HALEY JOHNSON IDC
NLON MEDICAL DEPARTMENT BLDG 76 NAVAL SUBMARINE BASE
GROTON, CT 06340
Phone number: 860-694-2795
Mailing Address
Mr. MARK HALEY JOHNSON IDC
197 CHARTER OAK DR
GROTON, CT 06340
Phone number: 860-865-0297
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