# NORTHEAST KINGDOM PHYSICAL THERAPY PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417175761
- **Authorized official:** MR. WILLIAM L HOGAN M.S.P.T. (OWNER)
- **Authorized official phone:** (802) 334-8558

## Contact information

- **Practice address:** 235 LAKEMONT RD, NEWPORT, VT 05855-9507
- **Practice address phone:** (802) 334-8558
- **Practice address fax:** (802) 334-8559
- **Mailing address:** 235 LAKEMONT RD, NEWPORT, VT 05855-9507
- **Mailing address phone:** (802) 334-8558
- **Mailing address fax:** (802) 334-8559

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2000X | Physical Therapy Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/23/2007
- **Last updated:** 09/19/2012