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General NPI Number Information
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NPI Number | 1215954904
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Entity Type | Organization
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Legal Business Name | MINDY COHEN INC
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 11 KILLBURN STREET
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City | BURLINGTON
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State | VT
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Zip | 05401
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Country | US
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Telephone | 802-865-9500
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Fax | 802-865-9559
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Provider Business Mailing Address
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Address Line | 11 KILLBURN STREET
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City | BURLINGTON
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State | VT
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Zip | 05401
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Country | US
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Telephone | 802-865-9500
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Fax | 802-865-9559
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Authorized Official
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Title or Position | PRESIDENT PHYSICAL THERAPIST
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Name | MINDY LEE COHEN
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Credential | MSPT
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Telephone | 802-865-9500
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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 | 3179
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License Number State | VT
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