Individual
LAURIE M. KENDALL-ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPT
Contact information
Practice address
636 CAMPBELL AVE, WEST HAVEN, CT 06516-4408
(203) 934-6690
(203) 934-6659
Mailing address
77 PECK HILL RD, WOODBRIDGE, CT 06525-1306
(203) 389-1738
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
002366
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002366
PHYSICAL THERAPY LICENSE
CT
Enumeration date
12/15/2006
Last updated
07/08/2007
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