Individual
ELEONORA S KISHELOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
1171 E PUTNAM AVE, BUILDING 2, SECOND FLOOR, RIVERSIDE, CT 06878-1426
(203) 637-1700
(203) 637-5447
Mailing address
1171 E PUTNAM AVE, BUILDING 2, SECOND FLOOR, RIVERSIDE, CT 06878-1426
(203) 637-1700
(203) 637-5447
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
008544
CT
225100000X
Physical Therapist
5501014394
MI
Other
Enumeration date
06/09/2009
Last updated
06/09/2009
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