Provider Demographics
NPI:1114188356
Name:VTPT, INC.
Entity Type:Organization
Organization Name:VTPT, INC.
Other - Org Name:POULIN & ASSOCIATES PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:CRITCHLOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-658-0949
Mailing Address - Street 1:PO BOX 486
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:VT
Mailing Address - Zip Code:05495-0486
Mailing Address - Country:US
Mailing Address - Phone:802-658-0949
Mailing Address - Fax:
Practice Address - Street 1:271 MOULTON RD
Practice Address - Street 2:
Practice Address - City:WAITSFIELD
Practice Address - State:VT
Practice Address - Zip Code:05673-7070
Practice Address - Country:US
Practice Address - Phone:802-658-0949
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-20
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty