MEDICARE: MRS. CHRISTINE MARIE FOURNIER 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	040.0002792	VT

General Provider Information

NPI Number	:	1346973146
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHRISTINE MARIE FOURNIER PT

Provider Business Mailing Address
First Line	:	686 DARLING HILL RD
Second Line	:
City	:	LYNDONVILLE
State	:	VT
Zip	:	05851-4515
Country	:	US
Telephone Number	:	802-751-5663
Fax Number	:

Provider Business Practice Location Address
First Line	:	601 RED VILLAGE RD
Second Line	:
City	:	LYNDONVILLE
State	:	VT
Zip	:	05851-9068
Country	:	US
Telephone Number	:	802-626-3361
Fax Number	:

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

Provider Enumeration Date	:	07/08/2022
Last Update Date	:	07/08/2022

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