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General NPI Number Information
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NPI Number | 1922285451
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Entity Type | Organization
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Legal Business Name | YELLOW HOUSE ENTERPRISES, LLC
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Dates
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Enumeration Date | 01/28/2008
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Last Update Date | 05/29/2019
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Provider Practice Location Address
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Address Line | 1 KENNEDY DR UNIT 3
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City | SOUTH BURLINGTON
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State | VT
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Zip | 05403-7152
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Country | US
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Telephone | 802-863-3323
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Fax |
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Provider Business Mailing Address
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Address Line | 1 KENNEDY DR
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City | SOUTH BURLINGTON
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State | VT
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Zip | 05403-7152
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Country | US
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Telephone | 802-863-3323
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KATHERINE DECAROLIS
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Credential | P.T.
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Telephone | 802-863-3323
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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 |
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License Number State |
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