Individual
JOHN JAY DRISCOLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
165 STATE ST, SUITE 100, NEW LONDON, CT 06320-6397
(860) 444-1949
Mailing address
165 STATE ST, SUITE 100, NEW LONDON, CT 06320-6397
(860) 444-1949
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
034263
CT
Other
Enumeration date
04/14/2015
Last updated
04/14/2015
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