MEDICARE: ANDREA L. ROBINSON 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	20739	MD

General Provider Information

NPI Number	:	1679808257
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA L. ROBINSON PT

Provider Business Mailing Address
First Line	:	PO BOX 35
Second Line	:
City	:	THETFORD
State	:	VT
Zip	:	05074-0035
Country	:	US
Telephone Number	:	802-356-9020
Fax Number	:

Provider Business Practice Location Address
First Line	:	1099 GODFREY RD
Second Line	:
City	:	EAST THETFORD
State	:	VT
Zip	:	05043-9682
Country	:	US
Telephone Number	:	802-356-9020
Fax Number	:

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

Provider Enumeration Date	:	10/15/2009
Last Update Date	:	10/15/2009

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