Provider Demographics
NPI:1700969904
Name:RAINEY, CHAD HOWARD (PT)
Entity Type:Individual
Prefix:MR
First Name:CHAD
Middle Name:HOWARD
Last Name:RAINEY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 ESSEX WAY STE 105
Mailing Address - Street 2:
Mailing Address - City:ESSEX JUNCTION
Mailing Address - State:VT
Mailing Address - Zip Code:05452-3394
Mailing Address - Country:US
Mailing Address - Phone:802-879-8300
Mailing Address - Fax:802-879-9300
Practice Address - Street 1:7 ESSEX WAY STE 105
Practice Address - Street 2:
Practice Address - City:ESSEX JUNCTION
Practice Address - State:VT
Practice Address - Zip Code:05452-3394
Practice Address - Country:US
Practice Address - Phone:802-879-8300
Practice Address - Fax:802-879-9300
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT040-0003400225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
5274301OtherAPEX
4123837OtherMVP
VMC/EM1OtherCIGNA
VT06549870OtherBLUE CROSS
VTVN3378Medicare ID - Type Unspecified