Provider Demographics
NPI:1922711472
Name:EMPOWERED PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:EMPOWERED PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KAYLA
Authorized Official - Middle Name:
Authorized Official - Last Name:MATUSZEWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:802-490-1032
Mailing Address - Street 1:268 SILVER LN
Mailing Address - Street 2:
Mailing Address - City:VERNON
Mailing Address - State:VT
Mailing Address - Zip Code:05354-9419
Mailing Address - Country:US
Mailing Address - Phone:802-380-1736
Mailing Address - Fax:
Practice Address - Street 1:316 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:BRATTLEBORO
Practice Address - State:VT
Practice Address - Zip Code:05301-3672
Practice Address - Country:US
Practice Address - Phone:802-490-1032
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-29
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy