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General NPI Number Information
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NPI Number | 1639482664
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Entity Type | Organization
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Legal Business Name | VERMONT SPINEWORKS AND REHABILITATION
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Dates
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Enumeration Date | 07/20/2010
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Last Update Date | 12/22/2010
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Provider Practice Location Address
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Address Line | 99 COURT ST
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City | MIDDLEBURY
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State | VT
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Zip | 05753-4448
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Country | US
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Telephone | 802-388-3400
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Fax | 802-388-3441
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Provider Business Mailing Address
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Address Line | 99 COURT ST
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City | MIDDLEBURY
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State | VT
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Zip | 05753-4448
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Country | US
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Telephone | 802-388-3400
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Fax | 802-388-3441
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Authorized Official
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Title or Position | MEMBER
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Name | TODD P. LEFKOE
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Credential | M.D.
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Telephone | 802-388-3400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 042-0009179
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License Number State | VT
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