Individual
MR. NORMAN STEVEN REEVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SUBMARINE IDC
Contact information
Practice address
159 TROUT AVE., GROTON, CT 06349-5159
(860) 851-1929
Mailing address
NUMI BLDG 159 NLON, APO, AE 06349-5159
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1043502701
SOLE PROPRIETOR
—
Enumeration date
05/12/2011
Last updated
05/13/2011
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