Individual
JUSTIN DENIS LONGHURST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
4640 S 3500 W, SUITE 3, WEST HAVEN, UT 84401-6521
(801) 689-0200
(801) 689-0201
Mailing address
128 MIDDLE ST, FARMINGTON, ME 04938-6937
(207) 778-6469
(207) 778-3486
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT4807
ME
Other
Enumeration date
07/30/2013
Last updated
12/22/2016
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