Individual
MR. JOHN THOMAS BRENNAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LO
Contact information
Practice address
300 S MAIN ST, WALLINGFORD, CT 06492-4603
(203) 626-5247
Mailing address
300 S MAIN ST, WALLINGFORD, CT 06492-4603
(203) 626-5247
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
001495
CT
Other
Enumeration date
06/17/2009
Last updated
06/17/2009
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