Individual
MISS KELLY DERUVO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
148 MAIN ST, KINGSTON, NH 03848-3222
(516) 594-1212
Mailing address
17 PARSONS WAY, KINGSTON, NH 03848-3657
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
026447-1
NY
225100000X
Physical Therapist
1223120
TX
225100000X
Physical Therapist
Primary
4194
NH
Other
Enumeration date
11/01/2006
Last updated
10/18/2019
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