Healthcare Provider Details

I. General information

NPI: 1972438760
Provider Name (Legal Business Name): LINDA M ORDONEZ LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

542 RAILROAD ST
ST JOHNSBURY VT
05819-1741
US

IV. Provider business mailing address

17 CHURCH ST APT 9
ST JOHNSBURY VT
05819-2196
US

V. Phone/Fax

Practice location:
  • Phone: 802-424-1434
  • Fax:
Mailing address:
  • Phone: 561-809-9097
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number164.0001956
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: