# KIDS REHABGYM INC.

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

## Provider details

- **NPI number:** 1457674038
- **Authorized official:** SHARON GUTWIN PHYSICAL THERAPIST (BOARD OF DIRECTORS-PRESIDENT)
- **Authorized official phone:** (802) 876-6000

## Contact information

- **Practice address:** 905 ROOSEVELT HIGHWAY, SUITE 115, COLCHESTER, VT 05446-4475
- **Practice address phone:** (802) 861-3600
- **Practice address fax:** (802) 861-2812
- **Mailing address:** 905 ROOSEVELT HIGHWAY, SUITE 115, COLCHESTER, VT 05446-4475
- **Mailing address phone:** (802) 861-3600
- **Mailing address fax:** (802) 861-2812

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 040-0001080 | VT | — |
| 225100000X | Physical Therapist | 040-0002123 | VT | — |
| 225X00000X | Occupational Therapist | 072-0051238 | VT | — |
| 261QP2000X | Physical Therapy Clinic/Center | 040-0002985 | VT | Yes |

## Other

- **Enumeration date:** 03/10/2010
- **Last updated:** 03/10/2010