Individual
HOLLY J GUDEAHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LO
Contact information
Practice address
625 SCHOOL ST, PUTNAM, CT 06260-2424
(860) 630-4634
(860) 928-4975
Mailing address
625 SCHOOL ST, PUTNAM, CT 06260-2424
(860) 630-4634
(860) 928-4975
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
001763
CT
Other
Enumeration date
12/13/2017
Last updated
12/13/2017
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