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Individual

KIMBERLY D ELLSWORTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
1 MARKET PL, SUITE #27&33, ESSEX JUNCTION, VT 05452-2942
(802) 878-9572
(802) 878-9592
Mailing address
201 SHIRLEY CIR, WILLISTON, VT 05495-7351
(802) 879-3545
(802) 878-9592

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0400003140
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1008564
VT
Enumeration date
07/06/2006
Last updated
07/08/2007
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