Organization
ELLSWORTH PHYSICAL THERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY D ELLSWORTH PT (PHYSICAL THERAPIST)
(802) 879-3545
Entity
Organization
Contact information
Practice address
1 MARKET PL, SUITE #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
261QP2000X
Physical Therapy Clinic/Center
Primary
0400003140
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1008564
—
VT
Enumeration date
07/06/2006
Last updated
08/22/2020
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