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Organization

ATP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOSHUA KEN HEENAN I.M.D. (DOCTOR OF INTEGRATED MEDICINE)
(203) 614-9635
Entity
Organization

Contact information

Practice address
75 SELLECK ST, STAMFORD, CT 06902-7207
(203) 614-9635
Mailing address
75 SELLECK ST, STAMFORD, CT 06902-7207
(203) 614-9635

Taxonomy

Speciality
Code
Description
License number
State
175F00000X
Naturopath
Primary
DNM 2813-609
CT

Other

Enumeration date
10/18/2016
Last updated
10/18/2016
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