Individual
KELLY HALLER-GILMOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
505 WILLARD AVE STE 1, NEWINGTON, CT 06111-2630
(860) 665-8265
Mailing address
59 OLDE HALL RD, HEBRON, CT 06248-1209
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4309
LICENSE#
CT
Enumeration date
08/27/2007
Last updated
04/30/2021
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