Provider Demographics
NPI:1811542913
Name:JAMES, ALICIA (PT DPT)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:JAMES
Suffix:
Gender:F
Credentials:PT DPT
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:
Other - Last Name:EVANCHO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:295 COLONIAL DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05753-8518
Mailing Address - Country:US
Mailing Address - Phone:802-398-2700
Mailing Address - Fax:802-398-2700
Practice Address - Street 1:295 COLONIAL DR
Practice Address - Street 2:
Practice Address - City:MIDDLEBURY
Practice Address - State:VT
Practice Address - Zip Code:05753-8518
Practice Address - Country:US
Practice Address - Phone:802-398-2700
Practice Address - Fax:802-398-2702
Is Sole Proprietor?:No
Enumeration Date:2019-08-06
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT040.0134090225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist