Provider Demographics
NPI:1083773436
Name:DEE PHYSICAL THERAPY SERVICES PLC
Entity Type:Organization
Organization Name:DEE PHYSICAL THERAPY SERVICES PLC
Other - Org Name:DEE PHYSICAL THERAPY SERVICES LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:DEE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:802-865-0010
Mailing Address - Street 1:23 SAN REMO DRIVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05403
Mailing Address - Country:US
Mailing Address - Phone:802-865-0010
Mailing Address - Fax:802-865-0050
Practice Address - Street 1:23 SAN REMO DRIVE
Practice Address - Street 2:
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403
Practice Address - Country:US
Practice Address - Phone:802-865-0010
Practice Address - Fax:802-865-0050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2019-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT59435OtherBCBS PROVIDER NUMBER
VT0VN3242Medicaid
VT59435OtherBCBS PROVIDER NUMBER