Individual
MATTHEW JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
51 ARMSTRONG RD, ENFIELD, CT 06082-2731
(860) 763-4636
Mailing address
51 ARMSTRONG RD, ENFIELD, CT 06082-2731
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT.0002758
CO
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
12/12/2017
Last updated
01/13/2026
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