Provider Demographics
NPI:1336284769
Name:SCHUG, VANCE II (ATC,PES)
Entity Type:Individual
Prefix:MR
First Name:VANCE
Middle Name:
Last Name:SCHUG
Suffix:II
Gender:M
Credentials:ATC,PES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 LAPLATTE CIR
Mailing Address - Street 2:
Mailing Address - City:SHELBURNE
Mailing Address - State:VT
Mailing Address - Zip Code:05482-6823
Mailing Address - Country:US
Mailing Address - Phone:802-985-2670
Mailing Address - Fax:
Practice Address - Street 1:78 EASTWOOD DR
Practice Address - Street 2:
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-4402
Practice Address - Country:US
Practice Address - Phone:802-658-0949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT10400000272255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer