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General NPI Number Information
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NPI Number | 1053268409
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Entity Type | Individual
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Provider Name | MICHAELA CORNBROOKS DPT
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Gender | Female
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Dates
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Enumeration Date | 03/13/2026
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Last Update Date | 03/13/2026
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Provider Practice Location Address
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Address Line | 32 COTTONWOOD DR STE 100
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City | WILLISTON
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State | VT
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Zip | 05495-4047
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Country | US
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Telephone | 802-764-0046
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Fax |
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Provider Business Mailing Address
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Address Line | 346 JERICHO RD APT 2
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City | RICHMOND
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State | VT
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Zip | 05477-9337
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Country | US
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Telephone | 802-338-6409
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 040.0134658
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License Number State | VT
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