Organization
MANCHESTER ORTHOPEDIC SURGERY & SPORT MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WELLS C JACOBSON M.D. (PRESIDENT)
(860) 646-0188
Entity
Organization
Contact information
Practice address
36 HAYNES ST, MANCHESTER, CT 06040-4105
(860) 646-0188
Mailing address
36 HAYNES ST, MANCHESTER, CT 06040-4105
(860) 646-0188
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
07/16/2006
Last updated
06/09/2008
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