Individual
JEREMY R CARROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.AC., MAOM
Contact information
Practice address
474 MAIN STREET, MIDDLEFIELD, CT 06455
(860) 704-9091
Mailing address
1083 CHAMBERLAIN HILL RD, MIDDLETOWN, CT 06457-5546
(860) 922-1073
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
000307
CT
Other
Enumeration date
06/18/2019
Last updated
06/18/2019
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