Individual
MRS. HEATHER GORMAN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PT, ATC
Contact information
Practice address
30 HAWTHORNE ST, MAPLE TREE PLACE, WILLISTON, VT 05495-8212
(802) 876-6000
Mailing address
30 HAWTHORNE ST, MAPLE TREE PLACE, WILLISTON, VT 05495-8212
(802) 876-6000
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
040-0003495
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1009343
—
VT
01
—
384013
MVP
VT
01
—
4691002
FAHC/VMC PREFERRED APEX
VT
01
—
58982
BC/BS
VT
Enumeration date
03/17/2006
Last updated
07/08/2007
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