Individual
ELLEN VAN WERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
465 WAVERLY OAKS RD STE 101, WALTHAM, MA 02452-8497
(781) 325-6180
Mailing address
465 WAVERLY OAKS RD STE 101, WALTHAM, MA 02452-8497
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
24347
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7018120
—
WA
Enumeration date
10/05/2010
Last updated
02/25/2022
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