Individual
REBECCA STREET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
120 GRAHAM WAY STE 110, SHELBURNE, VT 05482-7217
(802) 985-9360
Mailing address
426 INDUSTRIAL AVE, SUITE 190, WILLISTON, VT 05495-4448
(802) 860-4360
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
040.0094841
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1022197
—
VT
Enumeration date
08/21/2013
Last updated
06/10/2020
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