Provider Demographics
NPI:1396849808
Name:SHADROUI, MARGARET A (PT, CLT-LANA, MED)
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:A
Last Name:SHADROUI
Suffix:
Gender:F
Credentials:PT, CLT-LANA, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 COLLEGE PKWY
Mailing Address - Street 2:
Mailing Address - City:COLCHESTER
Mailing Address - State:VT
Mailing Address - Zip Code:05446-3007
Mailing Address - Country:US
Mailing Address - Phone:802-847-1901
Mailing Address - Fax:801-847-6943
Practice Address - Street 1:21 NASH PL
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-1420
Practice Address - Country:US
Practice Address - Phone:802-859-9021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0400000929225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist