Provider Demographics
NPI:1114150315
Name:KLOPPENBURG, BARBARA (PT)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:
Last Name:KLOPPENBURG
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 SOUTH RD
Mailing Address - Street 2:
Mailing Address - City:STOWE
Mailing Address - State:VT
Mailing Address - Zip Code:05672-4369
Mailing Address - Country:US
Mailing Address - Phone:718-644-7354
Mailing Address - Fax:
Practice Address - Street 1:43 STARR FARM RD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05408-1321
Practice Address - Country:US
Practice Address - Phone:802-863-6384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-03
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT040.0052739208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation