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Individual

MR. MALVIN CHARLES WARE SR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMT

Contact information

Practice address
40 ORCHARD ST, NEW LONDON, CT 06320-4818
(860) 389-2542
Mailing address
40 ORCHARD STREET, NEW LONDON, CT 06320
(860) 389-2545

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
006450
CT

Other

Enumeration date
12/17/2010
Last updated
12/17/2010
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