Provider Demographics
NPI:1073551792
Name:MATUNAS, ALLISON CONRAD (PT)
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:CONRAD
Last Name:MATUNAS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:CONRAD
Other - Last Name:STEELE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 892
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05250-0892
Mailing Address - Country:US
Mailing Address - Phone:802-375-9200
Mailing Address - Fax:802-375-9288
Practice Address - Street 1:2802 ROUTE 7A
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05250
Practice Address - Country:US
Practice Address - Phone:802-375-9200
Practice Address - Fax:802-375-9288
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0400003556225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist