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General NPI Number Information
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NPI Number | 1811614928
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Entity Type | Individual
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Provider Name | MAKAYLA E KING ATC, DPT, PT
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Gender | Female
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Dates
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Enumeration Date | 10/20/2022
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Last Update Date | 06/13/2025
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Provider Practice Location Address
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Address Line | 789 PINE ST
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City | BURLINGTON
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State | VT
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Zip | 05401-4924
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Country | US
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Telephone | 802-324-7178
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Fax |
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Provider Business Mailing Address
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Address Line | 113 WOODLAWN RD
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City | BURLINGTON
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State | VT
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Zip | 05408-5721
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Country | US
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Telephone | 802-324-7178
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 104.0133987
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License Number State | VT
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 040.0134937
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License Number State | VT
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