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Individual

JUSTIN RICHARD LEDUC

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ATC

Contact information

Practice address
300 SUMMIT ST, FERRIS ATHLETIC CENTER, HARTFORD, CT 06106-3100
(504) 491-1823
Mailing address
220 W MAIN ST APT 10, PLANTSVILLE, CT 06479-1150
(860) 378-4754

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Enumeration date
10/18/2005
Last updated
10/30/2008
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