Individual
KEVIN PATRICK MACKRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
71 HAYNES ST, MANCHESTER, CT 06040-4188
(860) 646-1222
Mailing address
112 MANSFIELD AVE, WILLIMANTIC, CT 06226-2045
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
1.076843
CT
Other
Enumeration date
11/15/2018
Last updated
07/30/2024
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