Provider First Line Business Practice Location Address:
16 MUNSON RD UNIVERSITY OF CONNECTICUT
Provider Second Line Business Practice Location Address:
CORRECTIONAL MANAGED HEALTH CARE
Provider Business Practice Location Address City Name:
FARMINGTON
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06030-5386
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-763-6588
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/22/2010