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General NPI Number Information
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NPI Number | 1952408148
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Entity Type | Organization
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Legal Business Name | PHYSICAL THERAPY OPTIONS PLLC
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 02/25/2017
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Provider Practice Location Address
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Address Line | 5749 LOOP RD
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City | WESTFIELD
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State | VT
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Zip | 05874-9737
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Country | US
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Telephone | 802-744-2076
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Fax | 802-744-2757
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Provider Business Mailing Address
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Address Line | 5749 LOOP RD
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City | WESTFIELD
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State | VT
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Zip | 05874-9737
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Country | US
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Telephone | 802-744-2076
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Fax | 802-744-2757
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | MRS. REBECCA JANE BASILIERE
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Credential | PT
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Telephone | 802-744-2076
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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 | 0400002235
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License Number State | VT
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