| NPI | 1245658574 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORRAINE FARRELL Member 802-324-8455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VT 040.0002393) |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2014-04-03 |