Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 5890 | CT |
Y | 2251X0800X | Physical Therapist - Orthopedic | 005890 | CT |
NPI | 1073744165 |
---|---|
Provider Name | F. Michael Joseph |
First Address | West Hartford, CT 06107-1926 |
Second Address | Southington, CT 06489-3121 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2009 |
Last Update Date | 17/03/2016 |