Individual
MRS. JACQUELINE MOOD BOLSTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPT
Contact information
Practice address
11 KILBURN ST, BURLINGTON, VT 05401-8705
(802) 878-8352
Mailing address
2 DAMON DR, ESSEX JUNCTION, VT 05452-2924
(802) 878-8352
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
040-0002009
VT
Other
Enumeration date
11/11/2008
Last updated
11/11/2008
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