Individual
ANDRE JEROME MARIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SUB IDC
Contact information
Practice address
17 CYPRESS LN, GROTON, CT 06340-3004
(216) 256-3186
Mailing address
17 CYPRESS LN, GROTON, CT 06340-3004
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
03/10/2011
Last updated
03/10/2011
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