Individual
JOHN DAVID CLELLAND III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SUB IDC
Contact information
Practice address
1 WAHOO AVE, GROTON, CT 06349-2324
(330) 573-1202
Mailing address
168 ARROWOOD DR, GROTON, CT 06340-2509
(330) 573-1202
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
08/06/2013
Last updated
08/06/2013
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