Individual
KIM PERKINS KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, MED.
Contact information
Practice address
40 HIGH ST, MIDDLEBURY, VT 05753-1209
(802) 388-1153
(802) 388-1153
Mailing address
40 HIGH ST, MIDDLEBURY, VT 05753-1209
(802) 388-1153
(802) 388-1153
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
040-0002043
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19824
BLUE CROSS AND BLUE SHIEL
VT
01
—
43V600
MVP
VT
Enumeration date
07/17/2007
Last updated
07/17/2007
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