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General NPI Number Information
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NPI Number | 1629150644
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Entity Type | Individual
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Provider Name | VERA R KILLIAN PT
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Gender | Female
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 02/28/2017
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Provider Practice Location Address
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Address Line | 10 HIGGINS HWY SUITE 12
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City | MANSFIELD CENTER
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State | CT
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Zip | 06250-1437
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Country | US
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Telephone | 860-456-3772
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Fax | 860-456-4941
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Provider Business Mailing Address
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Address Line | 262 LAKE RD
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City | ANDOVER
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State | CT
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Zip | 06232-1709
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Country | US
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Telephone | 860-742-1859
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Fax | 860-456-4941
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 006689
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License Number State | CT
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