| NPI | 1164722716 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE LYNN TATRO Owner 802-393-9115 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VT 0400003460) |
| Enumeration Date | 2010-10-29 |
| Last Update Date | 2014-01-10 |