Healthcare Provider Details

I. General information

NPI: 1568086023
Provider Name (Legal Business Name): STOWE PHYSICAL THERAPY & PILATES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2020
Last Update Date: 07/30/2020
Certification Date: 07/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5217 STAGECOACH RD
MORRISTOWN VT
05661-9259
US

IV. Provider business mailing address

5217 STAGECOACH RD
MORRISTOWN VT
05661-9259
US

V. Phone/Fax

Practice location:
  • Phone: 802-279-7767
  • Fax:
Mailing address:
  • Phone: 802-279-7767
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: KATHERINE DWYER
Title or Position: OWNER, FOUNDER
Credential: DPT
Phone: 802-279-7767