Individual
BRYAR TAYLOR GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
159 TROUT AVE, GROTON, CT 06340
(860) 694-2876
Mailing address
132 NORTH ST APT 69, GROTON, CT 06340-3764
(203) 892-5527
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
08/09/2023
Last updated
08/09/2023
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