MEDICARE: MARGARET B MOLE P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	040-0000792	VT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053313155
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARGARET B MOLE P.T.

Provider Business Mailing Address
First Line	:	231 BONNET ST
Second Line	:
City	:	MANCHESTER CENTER
State	:	VT
Zip	:	05255-9357
Country	:	US
Telephone Number	:	802-236-8469
Fax Number	:	802-824-4175

Provider Business Practice Location Address
First Line	:	231 BONNET ST
Second Line	:
City	:	MANCHESTER CENTER
State	:	VT
Zip	:	05255-9357
Country	:	US
Telephone Number	:	802-236-8469
Fax Number	:	802-824-4175

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	07/08/2007

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