Individual
DR. MICHAEL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT, OCS, CSCS
Contact information
Practice address
20 OCEAN AVE, WEST HAVEN, CT 06516-7048
(203) 561-7714
Mailing address
PO BOX 16573, WEST HAVEN, CT 06516-0983
(860) 422-0878
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
Primary
9603
CT
Other
Enumeration date
11/05/2012
Last updated
03/23/2023
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