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Organization
BENNINGTON PHYSICAL THERAPY PC
Active
Organization
BENNINGTON PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY JOSEPH VIDETTO PT (PRESIDENT PHYSICAL THERAPIST)
(802) 447-2101
Entity
Organization
Contact information
Practice address
328 DEWEY ST, BENNINGTON, VT 05201-2225
(802) 447-2101
(802) 447-1902
Mailing address
328 DEWEY ST, BENNINGTON, VT 05201-2225
(802) 447-2101
(802) 447-1902
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
108183
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
66326
MOHAWK VALLEY PLAN
VT
01
—
BENN28712
VT BCBS
VT
Enumeration date
11/18/2005
Last updated
06/30/2008
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