Healthcare Provider Details

I. General information

NPI: 1508650946
Provider Name (Legal Business Name): SADIE MOORE THOMPSON DPT, PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2025
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 CATAMOUNT PARK
MIDDLEBURY VT
05753-4422
US

IV. Provider business mailing address

11 LOWER PLAINS RD
MIDDLEBURY VT
05753-8671
US

V. Phone/Fax

Practice location:
  • Phone: 802-388-4430
  • Fax:
Mailing address:
  • Phone: 802-349-4335
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number040.0134438
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: