Individual
BYRON ROY EASTERLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
245 LONG HILL RD, MIDDLETOWN, CT 06457-4063
(860) 227-6630
Mailing address
PO BOX 118, OLD SAYBROOK, CT 06475-0118
(860) 227-6630
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
000163
CT
Other
Enumeration date
10/10/2008
Last updated
10/10/2008
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