Individual
MS. JENNIFER JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LO
Contact information
Practice address
489 GOLD STAR HWY STE 100, GROTON, CT 06340-6227
(860) 445-2461
(860) 445-8512
Mailing address
489 GOLD STAR HWY STE 100, GROTON, CT 06340-6227
(860) 445-2461
(860) 445-8512
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
001354
CT
Other
Enumeration date
10/04/2021
Last updated
10/04/2021
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