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1982912903
JEREMIAH LOIUS KING
GROTON, CT
NPI
1982912903
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1710I1002X Military Health Care Provider Independent Duty Corpsman
Enumeration Date
2010-09-24
Last Update Date
2010-09-24
Business Address
MR. JEREMIAH LOIUS KING IDC
141 DEWEY AVE
GROTON, CT 06340-3337
Phone number: 228-313-6708
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Mailing Address
MR. JEREMIAH LOIUS KING IDC
141 DEWEY AVE
GROTON, CT 06340-3337
Phone number: 228-313-6708
Copy
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