Provider Demographics
NPI:1821343732
Name:LAMPHERE, ALIZA R (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ALIZA
Middle Name:R
Last Name:LAMPHERE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 CARMICHAEL ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ESSEX JUNCTION
Mailing Address - State:VT
Mailing Address - Zip Code:05452-3186
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:21 CARMICHAEL ST
Practice Address - Street 2:SUITE 101
Practice Address - City:ESSEX JUNCTION
Practice Address - State:VT
Practice Address - Zip Code:05452-3186
Practice Address - Country:US
Practice Address - Phone:802-878-8572
Practice Address - Fax:802-878-9592
Is Sole Proprietor?:No
Enumeration Date:2012-07-17
Last Update Date:2016-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT040.0085581225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist