Individual
MIA KERCADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LDO
Contact information
Practice address
1400 FARMINGTON AVE, BRISTOL, CT 06010-4701
(860) 585-1156
(860) 585-1160
Mailing address
1400 FARMINGTON AVE, BRISTOL, CT 06010-4701
(860) 585-1156
(860) 585-1160
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
1900
CT
Other
Enumeration date
12/11/2023
Last updated
12/11/2023
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