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Individual

CHRISTOPHER DAVID BURLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
SUBMARINE IDC

Contact information

Practice address
1 WAHOO AVE, GROTON, CT 06349-2324
(860) 694-4123
Mailing address
PO BOX 159, GROTON, CT 06349-5159

Taxonomy

Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
CT

Other

Enumeration date
03/21/2022
Last updated
03/21/2022
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