Organization
GRACE CENTER FOR HEMATOLOGY & ONCOLOGY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VIRGINIA MARIA TJAN-WETTSTEIN M.D. (OWNER)
(860) 539-3360
Entity
Organization
Contact information
Practice address
45 N MAIN ST, BRISTOL, CT 06010-8105
(860) 539-3360
Mailing address
45 N MAIN ST, BRISTOL, CT 06010-8105
(860) 539-3360
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
036026
CT
Other
Enumeration date
08/12/2008
Last updated
08/12/2008
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