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1912403049
JOEL DANIEL FLENNIKEN
BENNINGTON, VT
NPI
1912403049
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: MI 5502004108)
Enumeration Date
2018-04-05
Last Update Date
2018-04-05
Business Address
JOEL DANIEL FLENNIKEN
2 BLACKBERRY LN
BENNINGTON, VT 05201-2300
Phone number: 802-442-8525
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Mailing Address
JOEL DANIEL FLENNIKEN
532 GIBSON DR STE 100
ROSEVILLE, CA 95678-5878
Phone number: 916-546-2162
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