Healthcare Provider Details

I. General information

NPI: 1124618087
Provider Name (Legal Business Name): TRUE NORTH PELVIC PT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2021
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 N MAIN ST
WHITE RIVER JUNCTION VT
05001-7056
US

IV. Provider business mailing address

17 MEADOW VALLEY DR
CORNISH NH
03745-4647
US

V. Phone/Fax

Practice location:
  • Phone: 802-755-5678
  • Fax: 888-853-6970
Mailing address:
  • Phone: 802-755-5678
  • Fax: 888-853-6970

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: AMY WEBSTER HEALY
Title or Position: OWNER
Credential:
Phone: 802-755-5678