Individual
MR. GEORGE THOMAS CONNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
17 LANE DR, NEWFANE, VT 05345-9587
(802) 365-7269
(802) 365-7269
Mailing address
17 LANE DR, NEWFANE, VT 05345-9587
(802) 365-7269
(802) 365-7269
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0400003607
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00068291
BCBS
VT
05
—
101937
—
VT
01
—
4128427
MVP
—
Enumeration date
08/07/2006
Last updated
09/07/2010
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