Provider Demographics
NPI:1750969796
Name:BODY AND MIND PHYSICAL THERAPY, PLC
Entity type:Organization
Organization Name:BODY AND MIND PHYSICAL THERAPY, PLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:C
Authorized Official - Last Name:VOLK
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:802-363-5118
Mailing Address - Street 1:167 MONKTON RD # 101B
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:VT
Mailing Address - Zip Code:05443-5045
Mailing Address - Country:US
Mailing Address - Phone:802-453-7200
Mailing Address - Fax:802-329-2302
Practice Address - Street 1:167 MONKTON RD # 101B
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:VT
Practice Address - Zip Code:05443-5045
Practice Address - Country:US
Practice Address - Phone:802-453-7200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-31
Last Update Date:2022-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSportsGroup - Multi-Specialty
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty