Individual
BRYAN GOH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1013 FARMINGTON AVE, WEST HARTFORD, CT 06107-2181
(860) 236-9004
Mailing address
22 PALMER DR, EAST HARTFORD, CT 06118-3049
(860) 205-9711
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
1259
CT
Other
Enumeration date
04/11/2015
Last updated
04/11/2015
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