BRENDAN COBURN

MANCHESTER, CT
NPI1720480965
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy133V00000X Dietitian, Registered
(Licence: CT  03-912955)
Enumeration Date2014-09-18
Last Update Date2014-09-18
Business Address
-- BRENDAN COBURN RD
595 MAIN ST
MANCHESTER, CT 06040-5160
Phone number: 860-559-5178
Mailing Address
-- BRENDAN COBURN RD
568 FOSTER ST
SOUTH WINDSOR, CT 06074-2935
Phone number: 860-559-5178
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