Individual
IVAN LEAVITT BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
159 TROUT AVENUE, SUBASE NEW LONDON, GROTON, CT 06340
(847) 254-3904
Mailing address
235 CHARTER OAK DR, GROTON, CT 06340-2934
(847) 254-3904
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
07/21/2017
Last updated
07/21/2017
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