Individual
MARY DESAUTELS BASILIERE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS PT
Contact information
Practice address
790 COLLEGE PKWY, COLCHESTER, VT 05446-3007
(802) 847-6887
Mailing address
7 DARTMOOR CT, ESSEX JCT, VT 05452-3048
(802) 878-3355
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
040-0000859
VT
Other
Enumeration date
10/04/2006
Last updated
07/08/2007
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