Individual
WEVERTON DEPAULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
240 INDIAN RIVER RD, C-3, ORANGE, CT 06477-3649
(203) 553-9797
Mailing address
240 INDIAN RIVER RD, C-3, ORANGE, CT 06477-3649
(203) 553-9797
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
001647
CT
Other
Enumeration date
07/31/2014
Last updated
07/31/2014
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