Individual
DR. CHARLES LEE MELLINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2600 POST RD, SOUTHPORT, CT 06890
(203) 255-4005
Mailing address
85 HALF MILE LANE, SOUTHPORT, CT 06890
(203) 255-6471
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0000841
CT
Other
Enumeration date
12/06/2006
Last updated
10/25/2010
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