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NPI Code Detail

MEDICARE: ANN VIRGINIA MATTICE

MEDICARE: ANN VIRGINIA MATTICE
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
1225200000XPhysical Therapy Assistant041.0112038VT

General Provider Information

NPI Number : 1891168407
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANN VIRGINIA MATTICE
Provider Business Mailing Address
First Line : 180 CROOKED PATH
Second Line :
City : ARLINGTON
State : VT
Zip : 05250-4470
Country : US
Telephone Number : 802-375-2558
Fax Number :
Provider Business Practice Location Address
First Line : 325 NORTH ST
Second Line :
City : BENNINGTON
State : VT
Zip : 05201-1937
Country : US
Telephone Number : 802-447-6548
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/04/2015
Last Update Date : 01/24/2016

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Directions to “ ANN VIRGINIA MATTICE ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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