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1760668792
MARK MAMMOTH
GROTON, CT
NPI
1760668792
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date
2008-01-22
Last Update Date
2008-01-22
Business Address
Mr. MARK MAMMOTH
1 WAHOO DRIVE NAVAL BRANCH HEALTH CLINIC
GROTON, CT 06349-5600
Phone number: 860-694-2377
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Mailing Address
Mr. MARK MAMMOTH
1 WAHOO DRIVE NAVAL BRANCH HEALTH CLINIC
GROTON, CT 06349-5600
Phone number: 860-694-2377
Copy
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