Individual
DR. JASON RONALD DELISLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
178 HARTFORD RD, MANCHESTER, CT 06040-5986
(860) 649-9973
(860) 647-7424
Mailing address
178 HARTFORD RD, MANCHESTER, CT 06040-5986
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
002748
CT
Other
Enumeration date
11/17/2008
Last updated
11/17/2008
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