Justin Tanco, IDC

NPI #1255183067 in Groton, Connecticut

Provider Information

NPI Number: 1255183067
Entity Type: Individual
Name: Justin Tanco, IDC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Military Health Care Provider - Independent Duty Corpsman
Credential: IDC
Enumeration Date: Apr 4, 2024
Last Updated: Apr 4, 2024

Practice Location

Address: BLDG. 159 TROUT AVE
City: Groton
State: Connecticut
ZIP Code: 06349
Phone: (860) 694-2876

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Military Health Care Provider - Independent Duty Corpsman — Independent Duty Corpsman	1710I1002X	Primary

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