# PEDIATRIC PHYSICAL THERAPY SERVICES PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750580858
- **Authorized official:** KIM PERKINS KELLEY PT, MED. (PRESIDENT)
- **Authorized official phone:** (802) 388-1153

## Contact information

- **Practice address:** 40 HIGH ST, MIDDLEBURY, VT 05753-1209
- **Practice address phone:** (802) 388-1153
- **Practice address fax:** (802) 388-1153
- **Mailing address:** 40 HIGH ST, MIDDLEBURY, VT 05753-1209
- **Mailing address phone:** (802) 388-1153
- **Mailing address fax:** (802) 388-1153

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2251P0200X | Pediatric Physical Therapist | 040-0002043 | VT | Yes |

## Other

- **Enumeration date:** 07/17/2007
- **Last updated:** 07/17/2007