Individual
ROY L UNDERWOOD
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
SFIDC
Contact information
Practice address
1 WAHOO AVE, GROTON, CT 06340-2324
(860) 694-5139
Mailing address
238 CEMETERY RD, PLAINFIELD, CT 06374-1515
(860) 564-7989
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
03/03/2006
Last updated
07/08/2007
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