Russell Jennings Rider, IDC
Russell Jennings Rider, IDC is an Independent Duty Corpsman in Groton, Connecticut. Practices as a sole proprietor. Registered with an NPI since 2020.
- In the registry since
- 2020
Practice location Address checks out
159 Trout AveGroton, CT 06340
Phone: (860) 694-6464
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Independent Duty Corpsman (primary) | Taxonomy 1710I1002X |
|---|
Record details
| NPI number | 1609416189 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | IDC |
| Sole proprietor | Yes |
| NPI enumerated | January 13, 2020 |
| Last updated in NPPES | January 13, 2020 |
| Certification date | January 13, 2020 |
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