Organization
DPMDECKERPRCT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER R DECKER DPM (OWNER/PODIATRIST)
(860) 657-3668
Entity
Organization
Contact information
Practice address
300 HEBRON AVE, SUITE 211, GLASTONBURY, CT 06033-2176
(860) 657-3668
(860) 657-1678
Mailing address
196 PARKWAY S, SUITE 304, WATERFORD, CT 06385-1234
(860) 442-7027
(860) 437-2236
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
000853
CT
Other
Enumeration date
07/28/2011
Last updated
07/28/2011
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