Individual
ETHAN RYAN DICKINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1080 DAY HILL RD, WINDSOR, CT 06095-1781
(860) 298-8442
Mailing address
55 OVERLOOK WAY, CANAAN, NH 03741-7101
(603) 359-7746
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12325
CT
Other
Enumeration date
05/31/2019
Last updated
08/26/2019
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