Individual
CAROLYNNE FAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
32 STACY ST, MILTON, VT 05468-4161
(802) 893-1642
Mailing address
32 STACY ST, MILTON, VT 05468-4161
(802) 893-1642
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
01/14/2021
Last updated
01/14/2021
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