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General NPI Number Information
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NPI Number | 1164509980
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Entity Type | Organization
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Legal Business Name | NORTHERN PHYSICAL THERAPY PC
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 04/20/2016
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Provider Practice Location Address
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Address Line | 569 MAIN ST
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City | LYNDONVILLE
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State | VT
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Zip | 05851
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Country | US
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Telephone | 802-626-4224
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Fax | 802-626-5042
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Provider Business Mailing Address
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Address Line | PO BOX 1346
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City | LYNDONVILLE
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State | VT
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Zip | 05851-1346
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Country | US
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Telephone | 802-626-4224
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Fax | 802-626-5042
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Authorized Official
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Title or Position | VP OF ADMIN
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Name | AMANDA PALMER
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Credential |
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Telephone | 802-626-4224
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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