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1790403137
BALY JUAN SEO PARK
FARMINGTON, CT
NPI
1790403137
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: CT 13568)
Enumeration Date
2022-08-22
Last Update Date
2022-09-06
Business Address
BALY JUAN SEO PARK
263 FARMINGTON AVE
FARMINGTON, CT 06030-0001
Phone number: 679-860-2000
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Mailing Address
BALY JUAN SEO PARK
10 TALCOTT RIDGE RD UNIT G
FARMINGTON, CT 06032-3513
Phone number: 959-225-0288
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