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General NPI Number Information
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NPI Number | 1114188356
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Entity Type | Organization
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Legal Business Name | VTPT, INC.
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Dates
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Enumeration Date | 06/20/2008
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Last Update Date | 06/20/2008
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Provider Practice Location Address
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Address Line | 271 MOULTON RD
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City | WAITSFIELD
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State | VT
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Zip | 05673-7070
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Country | US
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Telephone | 802-658-0949
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 486
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City | WILLISTON
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State | VT
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Zip | 05495-0486
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Country | US
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Telephone | 802-658-0949
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | CYNTHIA A CRITCHLOW
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Credential |
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Telephone | 802-658-0949
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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 |
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License Number State | VT
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