Provider Demographics
NPI:1407912041
Name:SCRIBNER, DAVID WAYNE (PT)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:WAYNE
Last Name:SCRIBNER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:DAVID
Other - Middle Name:
Other - Last Name:SCRIBNER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:82 LAFAYETTE STREET
Mailing Address - Street 2:
Mailing Address - City:ST JOHNSBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05819
Mailing Address - Country:US
Mailing Address - Phone:802-748-8831
Mailing Address - Fax:
Practice Address - Street 1:1129 MAIN ST
Practice Address - Street 2:
Practice Address - City:ST JOHNSBURY
Practice Address - State:VT
Practice Address - Zip Code:05819-2601
Practice Address - Country:US
Practice Address - Phone:802-748-8831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2019-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0400002277225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0803208Y0VT01OtherANTHEM
7462386001OtherCIGNA
VT0009395Medicaid
VTVT9395Medicare ID - Type Unspecified