Individual
NICOLE ELLROD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
97 SALMON BROOK ST, GRANBY, CT 06035
(860) 844-8912
Mailing address
97 SALMON BROOK ST, GRANBY, CT 06035
(860) 844-8912
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
007745
CT
Other
Enumeration date
10/03/2006
Last updated
07/08/2007
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