Most Relevant Information
Provider Data
| NPI Number: | 1003349739 |
| Provider Name: | COREY RYAN DWYER |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/10/2017 |
| Last Updated: | 07/11/2023 |
Provider Practice Location
263 FARMINGTON AVE
FARMINGTON
CT
060324038
Practice Location Phone/Fax
| Phone: | 8606796600 |
| Fax: | 8606792109 |
Provider Mailing Location
263 FARMINGTON AVE
FARMINGTON
CT
060321956
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |