Provider Demographics
NPI:1346318565
Name:MOMENTUM PHYSICAL THERAPY PLC
Entity Type:Organization
Organization Name:MOMENTUM PHYSICAL THERAPY PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MAURA
Authorized Official - Middle Name:M
Authorized Official - Last Name:GUYER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:802-864-6262
Mailing Address - Street 1:10 FARRELL ST STE 7
Mailing Address - Street 2:
Mailing Address - City:S BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05403-6371
Mailing Address - Country:US
Mailing Address - Phone:802-864-6262
Mailing Address - Fax:802-864-6252
Practice Address - Street 1:10 FARRELL ST STE 7
Practice Address - Street 2:
Practice Address - City:S BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-6371
Practice Address - Country:US
Practice Address - Phone:802-864-6262
Practice Address - Fax:802-864-6252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT040-003494225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty