Provider Demographics
NPI:1619204617
Name:CHIRIATTI, AMY L (MPT)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:L
Last Name:CHIRIATTI
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1001
Mailing Address - Street 2:
Mailing Address - City:WILDER
Mailing Address - State:VT
Mailing Address - Zip Code:05088-1001
Mailing Address - Country:US
Mailing Address - Phone:608-212-1797
Mailing Address - Fax:
Practice Address - Street 1:331 OLCOTT DR STE U2
Practice Address - Street 2:
Practice Address - City:WHITE RIVER JUNCTION
Practice Address - State:VT
Practice Address - Zip Code:05001-9263
Practice Address - Country:US
Practice Address - Phone:802-295-7333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-11
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT040.0051603225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist