Healthcare Provider Details

I. General information

NPI: 1891749479
Provider Name (Legal Business Name): CHOICE PHYSICAL THERAPY OF ST ALBANS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 11/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 CHAMPLAIN CMNS SUITE 1
SAINT ALBANS VT
05478-1563
US

IV. Provider business mailing address

3 CHAMPLAIN CMNS SUITE 1
SAINT ALBANS VT
05478-1563
US

V. Phone/Fax

Practice location:
  • Phone: 802-524-1155
  • Fax: 802-524-2664
Mailing address:
  • Phone: 802-524-1155
  • Fax: 802-524-2664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. LEANNE MARIE BLANCHARD
Title or Position: CLINICAL DIRECTOR
Credential: PT
Phone: 802-524-1155