Provider Demographics
NPI:1033887906
Name:GREEN MOUNTAIN PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:GREEN MOUNTAIN PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:PAXSON
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, OCS
Authorized Official - Phone:802-272-4267
Mailing Address - Street 1:701 E HOLLY ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-4712
Mailing Address - Country:US
Mailing Address - Phone:360-230-8033
Mailing Address - Fax:425-315-7024
Practice Address - Street 1:701 E HOLLY ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4712
Practice Address - Country:US
Practice Address - Phone:360-230-8033
Practice Address - Fax:425-315-7024
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GREEN MOUNTAIN PHYSICAL THERAPY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-09-03
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSportsGroup - Single Specialty