Provider Demographics
NPI:1487814679
Name:TREMBLAY, RICHARD SCOTT (PT, DPT)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:SCOTT
Last Name:TREMBLAY
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 HUNTINGTON RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VT
Mailing Address - Zip Code:05477-9708
Mailing Address - Country:US
Mailing Address - Phone:802-434-8495
Mailing Address - Fax:
Practice Address - Street 1:61 HUNTINGTON RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VT
Practice Address - Zip Code:05477-9708
Practice Address - Country:US
Practice Address - Phone:802-434-8495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-11
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT040.0077611225100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist