Provider Demographics
NPI:1073120473
Name:VMPT
Entity Type:Organization
Organization Name:VMPT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNCRIEF
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:917-664-3453
Mailing Address - Street 1:1404 LARKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-2539
Mailing Address - Country:US
Mailing Address - Phone:917-664-3453
Mailing Address - Fax:
Practice Address - Street 1:3701 KERBEY LN
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-6217
Practice Address - Country:US
Practice Address - Phone:917-664-3453
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-29
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy