Organization
BREAKAWAY HEALTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIM BOMBARD APRN (OWNER)
(860) 214-4513
Entity
Organization
Contact information
Practice address
843 MAIN ST # 15, MANCHESTER, CT 06040-6020
(860) 648-3001
(860) 648-3003
Mailing address
694 PALISADO AVE, WINDSOR, CT 06095-2037
(860) 214-4513
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
11/18/2022
Last updated
12/18/2024
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