Individual
DR. JEREMY EARL PRUDHOMME
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D
Contact information
Practice address
495 UNION ST STE 1082, WATERBURY, CT 06706-1285
(203) 591-8353
Mailing address
495 UNION ST STE 1082, WATERBURY, CT 06706-1285
(203) 591-8353
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2725
CT
Other
Enumeration date
08/28/2007
Last updated
08/28/2007
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