Individual
JONATHAN PATRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
6 DAVIS RD W, OLD LYME, CT 06371-1448
(860) 434-9155
Mailing address
6 DAVIS RD W, OLD LYME, CT 06371-1448
(860) 434-9155
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2350
CT
Other
Enumeration date
08/27/2009
Last updated
08/27/2009
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