Provider Demographics
NPI:1275610388
Name:ROYLANCE, JOSHUA PAUL (PT)
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:PAUL
Last Name:ROYLANCE
Suffix:
Gender:M
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:PO BOX 28
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:VT
Mailing Address - Zip Code:05091-0028
Mailing Address - Country:US
Mailing Address - Phone:802-457-4213
Mailing Address - Fax:802-457-9870
Practice Address - Street 1:1489 SOUTH RD
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:VT
Practice Address - Zip Code:05091-4537
Practice Address - Country:US
Practice Address - Phone:802-457-4213
Practice Address - Fax:802-457-9870
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024582-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist