Individual
MRS. ELLY R. VENTURA
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
ATC/L
Contact information
Practice address
190 COLLEGE DRIVE, GLENBROOK GYM, CASTLETON, VT 05735
(802) 468-1102
Mailing address
PO BOX 81, POULTNEY, VT 05764-0081
(518) 642-1028
(802) 468-2189
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
104-0000118
VT
Other
Enumeration date
02/27/2006
Last updated
07/08/2007
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