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Individual

KENNETH BLUM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
100 GREYROCK PLACE, STAMFORD TOWN CENTER, STAMFORD, CT 06901-3118
(203) 359-9600
(203) 975-8336
Mailing address
100 GREYROCK PLACE, STAMFORD TOWN CENTER, STAMFORD, CT 06901-3118
(203) 359-9600
(203) 975-8336

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
961
CT

Other

Enumeration date
09/19/2006
Last updated
07/08/2007
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