MEDICARE: MR. DAYTON RAYMOND CONTOIS 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	0400002919	VT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740224302
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAYTON RAYMOND CONTOIS PT

Provider Business Mailing Address
First Line	:	1896 QUAKER VILLAGE RD
Second Line	:
City	:	WEYBRIDGE
State	:	VT
Zip	:	05753-9644
Country	:	US
Telephone Number	:	802-545-2045
Fax Number	:

Provider Business Practice Location Address
First Line	:	115 PORTER DR
Second Line	:
City	:	MIDDLEBURY
State	:	VT
Zip	:	05753-8423
Country	:	US
Telephone Number	:	802-388-4777
Fax Number	:

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

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	07/09/2007

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