Individual
STACEY A WHITFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
111 COLCHESTER AVE, BURLINGTON, VT 05401-1473
(802) 847-2450
Mailing address
8 EICHEN CT, TICONDEROGA, NY 12883-3201
(518) 837-1446
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
006677
NY
225200000X
Physical Therapy Assistant
Primary
041.0063417
VT
Other
Enumeration date
02/18/2010
Last updated
03/01/2017
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