Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | PT4149 | ME |
N | 2251N0400X | Physical Therapist - Neurology | 3420 | NM |
NPI | 1558533216 |
---|---|
Provider Name | Veronica Kilbourn |
First Address | Brunswick, ME 04011-3218 |
Second Address | Brunswick, ME 04011-3218 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2008 |
Last Update Date | 09/06/2015 |