Individual
MR. KIM NEELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.O.
Contact information
Practice address
5 KENNEDY DR, PUTNAM, CT 06260-1939
(860) 928-6321
(860) 928-2239
Mailing address
5 KENNEDY DR, PUTNAM, CT 06260-1939
(860) 928-6321
(860) 928-2239
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
812
CT
Other
Enumeration date
10/06/2006
Last updated
07/09/2007
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