Individual
JERMAINE RICHARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
3303 MAIN ST, STRATFORD, CT 06614-4869
(203) 377-2220
Mailing address
PO BOX 3072, WESPORT, CT 06880
(203) 993-9198
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
033258
CT
Other
Enumeration date
04/25/2012
Last updated
04/25/2012
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