Provider Demographics
NPI:1407961212
Name:CYNTHIA ALDRICH, PT, LTD
Entity Type:Organization
Organization Name:CYNTHIA ALDRICH, PT, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALDRICH
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:802-885-1600
Mailing Address - Street 1:160 WALL ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VT
Mailing Address - Zip Code:05156-3528
Mailing Address - Country:US
Mailing Address - Phone:802-885-1600
Mailing Address - Fax:802-885-1600
Practice Address - Street 1:160 WALL ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VT
Practice Address - Zip Code:05156-3528
Practice Address - Country:US
Practice Address - Phone:802-885-1600
Practice Address - Fax:802-885-1600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0400002166225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0009701Medicaid
VTVT9701Medicare PIN
VTVN3128Medicare ID - Type UnspecifiedMEDICARE GROUP #