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General NPI Number Information
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NPI Number | 1902232499
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Entity Type | Individual
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Provider Name | MICHELE POMPILIO-FRY OTR
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Gender | Female
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Dates
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Enumeration Date | 09/17/2013
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Last Update Date | 09/17/2013
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Provider Practice Location Address
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Address Line | 596 SHELDON RD
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City | SAINT ALBANS
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State | VT
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Zip | 05478-8011
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Country | US
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Telephone | 802-524-6534
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Fax |
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Provider Business Mailing Address
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Address Line | 1111A ETHAN ALLEN AVE
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City | ESSEX JUNCTION
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State | VT
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Zip | 05452-4024
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 072.0096464
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License Number State | VT
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