Organization
KEENAN RUSSELL & MOORE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN JABLONSKI LO (PRESIDENT)
(203) 866-2775
Entity
Organization
Contact information
Practice address
650 WEST AVE, NORWALK, CT 06850-4020
(203) 866-2775
Mailing address
650 WEST AVE, NORWALK, CT 06850-4020
(203) 866-2775
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
001177
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004036364
—
CT
Enumeration date
12/05/2006
Last updated
07/16/2008
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