Individual
JOEL DANIEL FLENNIKEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2 BLACKBERRY LN, BENNINGTON, VT 05201-2300
(802) 442-8525
Mailing address
532 GIBSON DR STE 100, ROSEVILLE, CA 95678-5878
(916) 546-2162
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502004108
MI
Other
Enumeration date
04/05/2018
Last updated
04/05/2018
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