Provider Demographics
NPI:1942269550
Name:WEBSTER, CATHERINE A (PT)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:A
Last Name:WEBSTER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 TOWNLINE RD
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLE
Mailing Address - State:VT
Mailing Address - Zip Code:05458-2562
Mailing Address - Country:US
Mailing Address - Phone:802-372-3217
Mailing Address - Fax:
Practice Address - Street 1:30 HAWTHORNE ST
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:VT
Practice Address - Zip Code:05495-8212
Practice Address - Country:US
Practice Address - Phone:803-876-6000
Practice Address - Fax:802-876-6003
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT040-002985225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT00860916OtherTRICARE
VT1006931Medicaid
VT230438OtherCIGNA-LOCAL
VT29166OtherBC/BS
VT9746108OtherCIGNA-NATIONAL
VT363323OtherMVP
VT4689601OtherFAHC-VMC PREFFERED APEX
VTVN3222Medicare ID - Type Unspecified