Individual
DR. GLEN JUNIOR FOREMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT, LAT, ATC
Contact information
Practice address
60 MARKET ST STE 130, AVON, CT 06001-4282
(860) 703-8505
Mailing address
339 MAIN ST, FARMINGTON, CT 06032-3618
(203) 988-5560
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
14.013794
CT
Other
Enumeration date
01/25/2017
Last updated
04/09/2023
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