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General NPI Number Information
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NPI Number | 1225688567
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Entity Type | Organization
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Legal Business Name | ENVISION REHAB AND PERFORMANCE LLC
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Dates
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Enumeration Date | 09/18/2019
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 566 MEADOW ST
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City | LITTLETON
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State | NH
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Zip | 03561-3603
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Country | US
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Telephone | 802-323-2903
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Fax |
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Provider Business Mailing Address
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Address Line | 436 MOHAWK DR
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City | EAST BURKE
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State | VT
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Zip | 05832-4408
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Country | US
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Telephone | 802-323-2903
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LANCE BERRY
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Credential |
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Telephone | 802-323-2903
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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