Healthcare Provider Details

I. General information

NPI: 1255360814
Provider Name (Legal Business Name): SYLVIA IRENE FJELD P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67 LINCOLN ST
ESSEX JCT VT
05452-3235
US

IV. Provider business mailing address

195 MAPLE RUN LN
STOWE VT
05672-4044
US

V. Phone/Fax

Practice location:
  • Phone: 802-878-9513
  • Fax: 802-878-9962
Mailing address:
  • Phone: 802-253-4557
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40-2584
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: