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1962031500
LUCAS REIDER VERSLAND
NEW BRITAIN, CT
NPI
1962031500
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2020-04-06
Last Update Date
2020-04-06
Business Address
LUCAS REIDER VERSLAND DO
100 GRAND ST
NEW BRITAIN, CT 06052-2016
Phone number: 860-224-5261
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Mailing Address
LUCAS REIDER VERSLAND DO
263 FARMINGTON AVE
FARMINGTON, CT 06030-0001
Phone number: 860-679-2147
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