Individual
ERMELINDA ELAINE ALVISO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IDC
Contact information
Practice address
TROUT AVE, GROTON, CT 06340
(860) 694-2876
Mailing address
8927 SANTA FE SPRINGS RD, WHITTIER, CA 90606-2822
(562) 322-1992
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
05/31/2019
Last updated
05/31/2019
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