| NPI | 1932353737 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DORRIE LYNNE MARTELL Physical Therapist 802-343-7503 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: VT 040.0067743) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VT 0400067743) |
| Enumeration Date | 2008-11-06 |
| Last Update Date | 2017-03-12 |