Provider Demographics
NPI:1326177221
Name:KURYLO, ELIZABETH S
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:S
Last Name:KURYLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:K
Other - Last Name:DENEEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:24 OLD SOUTH RD
Mailing Address - Street 2:
Mailing Address - City:AQUINNAH
Mailing Address - State:MA
Mailing Address - Zip Code:02535-1519
Mailing Address - Country:US
Mailing Address - Phone:508-955-9051
Mailing Address - Fax:508-955-9030
Practice Address - Street 1:24 OLD SOUTH RD
Practice Address - Street 2:
Practice Address - City:AQUINNAH
Practice Address - State:MA
Practice Address - Zip Code:02535-1519
Practice Address - Country:US
Practice Address - Phone:508-955-9051
Practice Address - Fax:508-955-9030
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2011-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA18648225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist