Individual
MS. CARLA JANE KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
43 SCHOOL ST, NORTH SPRINGFIELD, VT 05150-9751
(802) 886-2321
(802) 886-2567
Mailing address
43 SCHOOL ST, NORTH SPRINGFIELD, VT 05150-9751
(802) 886-2321
(802) 886-2567
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
0400002086
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00005118
BCBS
VT
01
—
08Y002456VT01
ANTHEM BCNH
NH
01
—
212100
CIGNA
—
01
—
43806
MOHAWK VALLEY PLAN
VT
01
—
VT975501
MEDICARE
VT
Enumeration date
09/15/2006
Last updated
03/08/2015
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