Healthcare Provider Details

I. General information

NPI: 1811027618
Provider Name (Legal Business Name): KAREN C WESTERVELT MS, PGD, PT, ATC, O
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 06/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1878 MOUNTAIN ROAD PINNACLE PHYSICAL THERAPY
STOWE VT
05672
US

IV. Provider business mailing address

50 BURTMILL LN
STOWE VT
05672-5135
US

V. Phone/Fax

Practice location:
  • Phone: 802-253-2273
  • Fax: 802-253-7754
Mailing address:
  • Phone: 802-253-2273
  • Fax: 802-253-7754

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number0400002721
License Number StateVT
# 2
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number1040000002
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: