Individual
BENJAMIN JOHNSON III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
202 CANAAN RD, STRATFORD, CT 06614-4611
(203) 260-1581
Mailing address
202 CANAAN RD, STRATFORD, CT 06614-4611
(203) 260-1581
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
001745
CT
Other
Enumeration date
09/12/2016
Last updated
09/12/2016
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