Healthcare Provider Details

I. General information

NPI: 1912053554
Provider Name (Legal Business Name): PINNACLE PHYSICAL THERAPY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 10/10/2023
Certification Date: 10/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1878 MOUNTAIN RD SUITE 1
STOWE VT
05672-4776
US

IV. Provider business mailing address

1878 MOUNTAIN RD SUITE 1
STOWE VT
05672-4776
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 Number040-0002513
License Number StateVT

VIII. Authorized Official

Name: MR. PHILIP L SWEET
Title or Position: DESIGNATED DIRECTOR
Credential: PT
Phone: 802-253-2273