Individual
VERNON GOODWIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
102 DEERWOOD DR, GROTON, CT 06340-2516
(541) 778-2050
Mailing address
102 DEERWOOD DR, GROTON, CT 06340-2516
(541) 778-2050
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
10/30/2014
Last updated
10/30/2014
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