Individual
PATRICIA M PATANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, PT
Contact information
Practice address
90 JENNIFER LN, MANCHESTER CENTER, VT 05255-9663
(802) 362-5831
Mailing address
90 JENNIFER LN, MANCHESTER CENTER, VT 05255-9663
(802) 362-5831
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0400003585
VT
225100000X
Physical Therapist
62-022037
NY
2255A2300X
Athletic Trainer
000798-1
NY
2255A2300X
Athletic Trainer
104-0000111
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00059975
BLUE CROSS BLUE SHIELD
VT
05
—
1010523
—
VT
01
—
4123886
MVP
—
Enumeration date
07/27/2006
Last updated
04/10/2008
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