MEDICARE: CATHERINE SELLS 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	011121	NY
2	225100000X	Physical Therapist	040-0003085	VT

General Provider Information

NPI Number	:	1104064310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHERINE SELLS PT

Provider Business Mailing Address
First Line	:	252 STATION RD
Second Line	:
City	:	NORTH HERO
State	:	VT
Zip	:	05474-9630
Country	:	US
Telephone Number	:	802-372-3424
Fax Number	:

Provider Business Practice Location Address
First Line	:	252 STATION RD
Second Line	:
City	:	NORTH HERO
State	:	VT
Zip	:	05474-9630
Country	:	US
Telephone Number	:	802-372-3424
Fax Number	:

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

Provider Enumeration Date	:	01/26/2009
Last Update Date	:	01/26/2009

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