Provider Demographics
NPI:1649419326
Name:POLLOCK, VALERIE K (PTA, CNMT)
Entity Type:Individual
Prefix:MS
First Name:VALERIE
Middle Name:K
Last Name:POLLOCK
Suffix:
Gender:F
Credentials:PTA, CNMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1319 TENNEY POND RD
Mailing Address - Street 2:
Mailing Address - City:WELLS RIVER
Mailing Address - State:VT
Mailing Address - Zip Code:05081-4418
Mailing Address - Country:US
Mailing Address - Phone:802-274-6641
Mailing Address - Fax:
Practice Address - Street 1:31 MIDDLE ST
Practice Address - Street 2:NORTHERN PHYSICAL THERAPY
Practice Address - City:LYNDONVILLE
Practice Address - State:VT
Practice Address - Zip Code:05851
Practice Address - Country:US
Practice Address - Phone:802-626-4224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-19
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0410000271225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant