Provider Demographics
NPI:1811955081
Name:APPLETREE BAY PHYSICAL THERAPY, INC
Entity type:Organization
Organization Name:APPLETREE BAY PHYSICAL THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:RUBMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-383-0400
Mailing Address - Street 1:1205 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05408-2751
Mailing Address - Country:US
Mailing Address - Phone:802-383-0400
Mailing Address - Fax:802-383-0420
Practice Address - Street 1:1205 NORTH AVE
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05408-2751
Practice Address - Country:US
Practice Address - Phone:802-383-0400
Practice Address - Fax:802-383-0420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT58566OtherBLUE CROSS/BLUE SHIELD
VT1008599Medicaid
VT1008599Medicaid