Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 006094 | CT |
N | 2251E1200X | Ergonomics | 006094 | CT |
N | 225XE1200X | Ergonomics | 006094 | CT |
N | 2251S0007X | Physical Therapist - Sports | 006094 | CT |
N | 2251X0800X | Physical Therapist - Orthopedic | 006094 | CT |
NPI | 1184635369 |
---|---|
Provider Name | Jonathan C Glenney |
First Address | Middletown, CT 06457-4777 |
Second Address | Middletown, CT 06457-4777 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2006 |
Last Update Date | 03/05/2019 |