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Individual

MR. JOHNATHON EUGENE ANDERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMT

Contact information

Practice address
1606 HOPMEADOW ST, SIMSBURY, CT 06070-1448
(860) 806-1509
Mailing address
117 HIGHLAND AVE, NEW HARTFORD, CT 06057-2026
(860) 605-3312

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
03-059546
CT

Other

Enumeration date
08/03/2011
Last updated
08/03/2011
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