Individual
ALAN GREGORY KING III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
92 OLIVIA ST APT 1, DERBY, CT 06418-1767
(475) 414-9454
Mailing address
92 OLIVIA ST APT 1, DERBY, CT 06418-1767
(475) 414-9454
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
0002292
CT
Other
Enumeration date
09/26/2023
Last updated
09/26/2023
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