Provider Demographics
NPI:1619242666
Name:TRANSITIONS PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:TRANSITIONS PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:MCCAULEY
Authorized Official - Last Name:FITZGERALD
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:802-578-7219
Mailing Address - Street 1:74 VT ROUTE 15
Mailing Address - Street 2:
Mailing Address - City:JERICHO
Mailing Address - State:VT
Mailing Address - Zip Code:05465-3011
Mailing Address - Country:US
Mailing Address - Phone:802-899-5200
Mailing Address - Fax:802-899-5800
Practice Address - Street 1:74 VT ROUTE 15
Practice Address - Street 2:
Practice Address - City:JERICHO
Practice Address - State:VT
Practice Address - Zip Code:05465-3011
Practice Address - Country:US
Practice Address - Phone:802-899-5200
Practice Address - Fax:802-899-5800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-08
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT040.0003694225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty