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NPI Code Detail

MEDICARE: TRACY M BENEDICT PT

MEDICARE:   TRACY M BENEDICT  PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist0400003344VT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
100049422OTHERVTBLUE CROSS BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
343V143OTHERMVP HEALTH CARE
4650020252OTHERRAILROAD MC

General Provider Information

NPI Number : 1346358520
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRACY M BENEDICT PT
Provider Business Mailing Address
First Line : 142 W TWIN OAKS TER
Second Line :
City : SOUTH BURLINGTON
State : VT
Zip : 05403-7132
Country : US
Telephone Number : 802-383-0676
Fax Number : 802-383-0678
Provider Business Practice Location Address
First Line : 142 W TWIN OAKS TER
Second Line :
City : SOUTH BURLINGTON
State : VT
Zip : 05403-7132
Country : US
Telephone Number : 802-383-0676
Fax Number : 802-383-0678
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2006
Last Update Date : 05/07/2026

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Directions to “ TRACY M BENEDICT PT” Practice Location

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