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Individual

DR. RONALD L MEDWICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
567 VAUXHALL STREET, WATERFORD, CT 06385
(860) 442-1466
(860) 442-3191
Mailing address
567 VAUXHALL STREET, WATERFORD, CT 06385
(860) 442-1466
(860) 442-3191

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
CT753
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004080941
CT
Enumeration date
09/16/2006
Last updated
01/21/2009
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