United States Air Force

NPI #1184921975 in West Hartford, Connecticut

Provider Information

NPI Number: 1184921975
Entity Type: Organization
Organization Name: United States Air Force
Primary Specialty: Military Hospital
Enumeration Date: Feb 14, 2011
Last Updated: Feb 14, 2011

Practice Location

Address: 15 HIGHLAND ST APT 102
City: West Hartford
State: Connecticut
ZIP Code: 06119-1300
Phone: (203) 347-5504

Authorized Official

Name: MR. RON DION CHANCE, M.A.
Title: CLINICAL PSYCHOLOGY DOCTORAL STUDEN
Phone: (203) 347-5504

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Military Hospital	286500000X	Primary

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