Individual
TAYLA JEAN WILLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
365 MONTAUK AVENUE, DEPARTMENT: SURGERY (INPATIENT), NEW LONDON, CT 06320
(860) 442-0711
(860) 444-4709
Mailing address
345 BANK STREET, UNIT #1 REAR, NEW LONDON, CT 06320
(860) 287-1302
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
6218
CT
Other
Enumeration date
08/07/2023
Last updated
08/07/2023
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