Individual
MR. JEREMIAH LOIUS KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
141 DEWEY AVE, GROTON, CT 06340-3337
(228) 313-6708
Mailing address
141 DEWEY AVE, GROTON, CT 06340-3337
(228) 313-6708
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
09/24/2010
Last updated
09/24/2010
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