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Individual

TALIA ANNE DEFORGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
98 HOSPITALITY DR, BARRE, VT 05641-5360
(802) 229-0308
Mailing address
98 HOSPITALITY DRIVE, BARRE, VT 05641
(802) 229-0308

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
041.0000513
VT

Other

Enumeration date
04/11/2017
Last updated
04/11/2017
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