Individual
MR. ADAM BADILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
600 MERIDIAN STREET EXT APT 1415, GROTON, CT 06340-4160
(619) 717-1658
Mailing address
600 MERIDIAN STREET EXT APT 1415, GROTON, CT 06340-4160
(619) 717-1658
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
F4477436
TX
Other
Enumeration date
07/22/2015
Last updated
07/22/2015
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