Individual
MISS GINA THERESA COURCELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
5 ALBERT CREE DR, RUTLAND, VT 05701-4601
(802) 775-1300
(802) 773-9300
Mailing address
5 ALBERT CREE DR, RUTLAND, VT 05701-4601
(802) 775-1300
(802) 773-9300
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
008318
CT
225100000X
Physical Therapist
Primary
0400097034
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008002058
—
CT
Enumeration date
05/22/2008
Last updated
09/26/2017
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