Individual
CAROLYN BAUMAN DESSUREAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
137 S MAIN ST, WATERBURY, VT 05676-1579
(802) 244-1140
Mailing address
137 S MAIN ST, WATERBURY, VT 05676-1579
(802) 244-1140
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
040-0003114
VT
Other
Enumeration date
11/06/2008
Last updated
08/02/2010
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