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NPI Code Detail

MEDICARE: MS. DIANE COLUCCI PT

MEDICARE: MS. DIANE COLUCCI 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
1225100000XPhysical Therapist040-0002027VT

General Provider Information

NPI Number : 1619076213
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DIANE COLUCCI PT
Provider Business Mailing Address
First Line : 156 BACON DR
Second Line :
City : SHELBURNE
State : VT
Zip : 05482-7496
Country : US
Telephone Number : 802-847-2547
Fax Number :
Provider Business Practice Location Address
First Line : 158 HURRICANE LN
Second Line :
City : WILLISTON
State : VT
Zip : 05495-2072
Country : US
Telephone Number : 802-847-0193
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2006
Last Update Date : 07/08/2007

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