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General NPI Number Information
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NPI Number | 1487762696
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Entity Type | Individual
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Provider Name | SUSAN CROMWELL P.T.
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Gender | Female
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Dates
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Enumeration Date | 08/28/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 790 COLLEGE PKWY
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City | COLCHESTER
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State | VT
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Zip | 05446-3007
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Country | US
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Telephone | 802-847-1902
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Fax | 802-847-6943
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Provider Business Mailing Address
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Address Line | 159 BEARTOWN RD
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City | UNDERHILL
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State | VT
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Zip | 05489-9369
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Country | US
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Telephone | 802-899-5471
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Fax | 802-847-6943
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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 | 2251N0400X
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Taxonomy Name | Neurology Physical Therapist
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License Number | 0400002466
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License Number State | VT
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