Individual
DONALD JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2900 MAIN ST, SUITE 1D, STRATFORD, CT 06614-4946
(203) 378-0092
(203) 375-4540
Mailing address
1931 BLACK ROCK TPKE, ATTN: CREDENTIALING, FAIRFIELD, CT 06825-3506
(203) 332-4363
(203) 330-6761
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10271
CT
Other
Enumeration date
08/08/2014
Last updated
08/08/2014
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