Provider Demographics
NPI:1841796497
Name:OSTERMAN, JANINE ANN (ATC)
Entity Type:Individual
Prefix:
First Name:JANINE
Middle Name:ANN
Last Name:OSTERMAN
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1667 COX BROOK RD
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:VT
Mailing Address - Zip Code:05663-6909
Mailing Address - Country:US
Mailing Address - Phone:802-793-0762
Mailing Address - Fax:
Practice Address - Street 1:1667 COX BROOK RD
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:VT
Practice Address - Zip Code:05663-6909
Practice Address - Country:US
Practice Address - Phone:802-793-0762
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-03
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT104.00001172255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer