Healthcare Provider Details

I. General information

NPI: 1932432341
Provider Name (Legal Business Name): ANDREA L. TROMBLEY PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2009
Last Update Date: 09/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 KILBURN ST
BURLINGTON VT
05401-4720
US

IV. Provider business mailing address

20 KILBURN ST
BURLINGTON VT
05401-4720
US

V. Phone/Fax

Practice location:
  • Phone: 802-864-9642
  • Fax:
Mailing address:
  • Phone: 802-864-9642
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number040-0003131
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: