Individual
MRS. STACEY R EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LO
Contact information
Practice address
333 KENNEDY DR STE L202, TORRINGTON, CT 06790-7201
(860) 482-9399
Mailing address
8 ARBOR RIDGE RD, TORRINGTON, CT 06790-2576
(270) 933-8084
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
001826
CT
Other
Enumeration date
10/09/2023
Last updated
10/09/2023
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