Provider Demographics
NPI:1962448993
Name:RAMBUR, STEPHEN M (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:M
Last Name:RAMBUR
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
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Mailing Address - Street 1:21 ESSEX WAY
Mailing Address - Street 2:SUITE 116
Mailing Address - City:ESSEX JUNCTION
Mailing Address - State:VT
Mailing Address - Zip Code:05452-3385
Mailing Address - Country:US
Mailing Address - Phone:802-879-8200
Mailing Address - Fax:802-879-9300
Practice Address - Street 1:21 ESSEX WAY
Practice Address - Street 2:SUITE 116
Practice Address - City:ESSEX JUNCTION
Practice Address - State:VT
Practice Address - Zip Code:05452-3385
Practice Address - Country:US
Practice Address - Phone:802-879-8200
Practice Address - Fax:802-879-9300
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2010-12-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VT0400003352225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT11461589OtherCAQH
VT00068727OtherBLUE CROSS BLUE SHIELD
VT68727OtherTVHP
VT1011584Medicaid
VT3352OtherFAHC
VT398053OtherMVP
VTVN3818Medicare PIN