Individual
HECTOR SALVADOR GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
2 BUSHNELL ST, GROTON, CT 06340-3306
(787) 431-4867
Mailing address
2 BUSHNELL ST, GROTON, CT 06340-3306
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
06/09/2019
Last updated
06/09/2019
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