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General NPI Number Information
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NPI Number | 1730702655
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Entity Type | Individual
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Provider Name | MADELINE HOBAUGH DPT
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Gender | Female
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Dates
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Enumeration Date | 05/27/2020
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Last Update Date | 05/27/2020
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Provider Practice Location Address
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Address Line | 475 SAINT PAUL ST
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City | BURLINGTON
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State | VT
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Zip | 05401-4869
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Country | US
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Telephone | 773-841-6398
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Fax |
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Provider Business Mailing Address
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Address Line | 642 SHELDON RD
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City | SAINT ALBANS
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State | VT
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Zip | 05478-8014
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Country | US
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Telephone |
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Fax |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 040.0134160
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License Number State | VT
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