Individual
RYAN PATRICK MCDONALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
57 WOLCOTT WOODS DR, SIMSBURY, CT 06070-1428
(860) 709-1648
Mailing address
15R HARTFORD AVE, GRANBY, CT 06035-2308
(860) 709-1648
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
6421
CT
Other
Enumeration date
05/03/2013
Last updated
05/03/2013
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