Individual
KENNETH MELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.O.
Contact information
Practice address
465 BRIDGEPORT AVE, SHELTON, CT 06484-4751
(203) 926-1189
Mailing address
465 BRIDGEPORT AVE, SHELTON, CT 06484-4751
(203) 926-1189
Taxonomy
Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
Primary
1127
CT
156FX1800X
Optician
1127
CT
Other
Enumeration date
05/29/2009
Last updated
05/29/2009
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