Provider First Line Business Practice Location Address:
10 TALCOTT NOTCH
Provider Second Line Business Practice Location Address:
UNIVERSITY OF CONNECTICUT HEALTH CENTER, DEPT OF PSYCH
Provider Business Practice Location Address City Name:
FARMINGTON
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06030-6410
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-679-6700
Provider Business Practice Location Address Fax Number:
860-679-6736
Provider Enumeration Date:
01/30/2007