Individual
MR. BRYAN KEITH ODITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APA-C
Contact information
Practice address
15 MOHEGAN AVE, NEW LONDON, CT 06320-8100
(860) 444-8207
(860) 444-8413
Mailing address
15 MOHEGAN AVE, NEW LONDON, CT 06320-8100
(860) 444-8207
(860) 444-8413
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA11519
TX
363AM0700X
Medical Physician Assistant
Primary
001247
CT
Other
Enumeration date
01/06/2006
Last updated
01/22/2025
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