MEDICARE: MRS. ALLISON CONRAD MATUNAS PT

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	0400003556	VT

General Provider Information

NPI Number	:	1073551792
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ALLISON CONRAD MATUNAS PT

Provider Business Mailing Address
First Line	:	PO BOX 892
Second Line	:
City	:	ARLINGTON
State	:	VT
Zip	:	05250-0892
Country	:	US
Telephone Number	:	802-375-9200
Fax Number	:	802-375-9288

Provider Business Practice Location Address
First Line	:	2802 ROUTE 7A
Second Line	:
City	:	ARLINGTON
State	:	VT
Zip	:	05250
Country	:	US
Telephone Number	:	802-375-9200
Fax Number	:	802-375-9288

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

Provider Enumeration Date	:	06/03/2006
Last Update Date	:	07/08/2007

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