Healthcare Provider Details

I. General information

NPI: 1427072081
Provider Name (Legal Business Name): DARCI LYNN WHITEHORNE MSPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DARCI LYNN MUNSON MSPT

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 09/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

279 BUSINESS ROUTE 4 STE 1
CENTER RUTLAND VT
05736-9701
US

IV. Provider business mailing address

5 ALBERT CREE DR VERMONT SPORTS MEDICINE CENTER
RUTLAND VT
05701
US

V. Phone/Fax

Practice location:
  • Phone: 802-775-4372
  • Fax: 802-775-4918
Mailing address:
  • Phone: 802-775-1300
  • Fax: 802-773-9300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number0400003671
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: