JACQUELYNE PHANAVONG

NEW BRITAIN, CT
NPI1730439597
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: CT  02813)
Enumeration Date2012-09-19
Last Update Date2017-02-15
Business Address
-- JACQUELYNE PHANAVONG
100 GRAND ST
NEW BRITAIN, CT 06052-2016
Phone number: 860-224-5675
Mailing Address
-- JACQUELYNE PHANAVONG
100 GRAND ST
NEW BRITAIN, CT 06052-2016
Phone number: 860-224-5675
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