Individual
MRS. ELLEN T POVEROMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
100 CUMMINGS CTR, SUITE 121Q, BEVERLY, MA 01915-6115
(978) 927-0907
Mailing address
22 ARLINGTON AVE, BEVERLY, MA 01915-1002
(978) 927-2528
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5499
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0395871
—
MA
Enumeration date
11/04/2005
Last updated
01/05/2011
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