Individual
MR. DAVID GEORGE HAYNESNORTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
5 LAKE ST, GROTON, CT 06340-3317
(860) 694-8226
Mailing address
5 LAKE ST, GROTON, CT 06340-3317
(860) 694-8226
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
05/07/2015
Last updated
05/07/2015
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