Individual
KRISTEN CONNOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3015 LIMITED LN NW, SUITE B, OLYMPIA, WA 98502-2638
(360) 709-0700
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2222
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
60662111
WA
225100000X
Physical Therapist
PT30121
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010060900
—
FL
Enumeration date
08/20/2015
Last updated
08/15/2016
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