Individual
KURT JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10 POND CT, WALLINGFORD, CT 06492-2142
(203) 605-7258
Mailing address
10 POND CT, WALLINGFORD, CT 06492-2142
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
12/22/2017
Last updated
12/22/2017
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