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Individual

MRS. MARYELLEN WILLETTE BOUTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHYSICAL THERAPIST

Contact information

Practice address
84 S MAIN ST, BARRE, VT 05641-4897
(802) 476-3305
(802) 476-0976
Mailing address
84 S MAIN ST, BARRE, VT 05641-4897
(802) 476-3305
(802) 476-0976

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0400003183
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
OVN 2233
VT
Enumeration date
06/12/2006
Last updated
09/18/2025
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