Individual
MR. JASON TODD GORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
USCG HQ, COMDT, (CG-1122), WASHINGTON, DC 20593-0001
(860) 444-8402
Mailing address
208 BENHAM RD, GROTON, CT 06340-5006
(860) 405-8128
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
02/28/2006
Last updated
11/16/2007
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