Provider Demographics
NPI:1679546683
Name:LUMBRA, KARA LEE (PT)
Entity Type:Individual
Prefix:MRS
First Name:KARA
Middle Name:LEE
Last Name:LUMBRA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:KARA
Other - Middle Name:LEE
Other - Last Name:BAILLARGEON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:2 CHAMPLAIN COMMONS
Mailing Address - Street 2:SUITE 4
Mailing Address - City:ST ALBANS
Mailing Address - State:VT
Mailing Address - Zip Code:05478
Mailing Address - Country:US
Mailing Address - Phone:802-524-1155
Mailing Address - Fax:802-524-2664
Practice Address - Street 1:2 CHAMPLAIN CMNS
Practice Address - Street 2:SUITE 4
Practice Address - City:ST ALBANS
Practice Address - State:VT
Practice Address - Zip Code:05478-1563
Practice Address - Country:US
Practice Address - Phone:802-524-1155
Practice Address - Fax:802-524-2664
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2012-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT04000034322251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTBAVN2724Medicare ID - Type Unspecified