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1316098619
KATHY C PROVENCHER
WATERBURY, VT
NPI
1316098619
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: VT 0400002724)
Enumeration Date
2007-01-15
Last Update Date
2015-09-28
Business Address
Ms. KATHY C PROVENCHER
137S MAIN ST
WATERBURY, VT 05676-1579
Phone number: 802-244-1140
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Mailing Address
Ms. KATHY C PROVENCHER
15 COOPER'S LANDING
WATERBURY, VT 05677-8335
Phone number: 802-244-6859
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