Individual
JEFFREY LAROUX VANASSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CCP, LP
Contact information
Practice address
114 WOODLAND ST, HARTFORD, CT 06105-1208
(860) 714-9720
Mailing address
114 WOODLAND ST, HARTFORD, CT 06105-1208
Taxonomy
Speciality
Code
Description
License number
State
242T00000X
Perfusionist
Primary
009
CT
Other
Enumeration date
07/09/2018
Last updated
07/09/2018
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