Provider Demographics
NPI:1811027618
Name:WESTERVELT, KAREN C (MS, PGD, PT, ATC, O)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:C
Last Name:WESTERVELT
Suffix:
Gender:F
Credentials:MS, PGD, PT, ATC, O
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 BURTMILL LN
Mailing Address - Street 2:
Mailing Address - City:STOWE
Mailing Address - State:VT
Mailing Address - Zip Code:05672-5135
Mailing Address - Country:US
Mailing Address - Phone:802-253-2273
Mailing Address - Fax:802-253-7754
Practice Address - Street 1:1878 MOUNTAIN ROAD
Practice Address - Street 2:PINNACLE PHYSICAL THERAPY
Practice Address - City:STOWE
Practice Address - State:VT
Practice Address - Zip Code:05672
Practice Address - Country:US
Practice Address - Phone:802-253-2273
Practice Address - Fax:802-253-7754
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0400002721225100000X
VT10400000022255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer