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Individual

MRS. KAREN CHANDLER WALLACE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MPT

Contact information

Practice address
10 GROVE STREET, SAXTONS RIVER, VT 05154-0174
(802) 869-2196
Mailing address
PO BOX 174, 10 GROVE STREET, SAXTONS RIVER, VT 05154-0174
(802) 869-2196

Taxonomy

Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
0400003229
VT
2251P0200X
Pediatric Physical Therapist
Primary
2311
NH

Other

Enumeration date
11/30/2007
Last updated
11/30/2007
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