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MAUREEN COREY GIBEAULT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
5 ALBERT CREE DR, VERMONT SPORTS MEDICINE CENTER, RUTLAND, VT 05701
(802) 775-1300
(802) 773-9300
Mailing address
5 ALBERT CREE DR, VERMONT SPORTS MEDICINE CENTER, RUTLAND, VT 05701
(802) 775-1300
(802) 773-9300

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
040-0002077
VT
225100000X
Physical Therapist
PT01710
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00004656
BCBS
VT
01
43425
MVP
01
4416928
AETNA
05
OVN2137
VT
Enumeration date
08/11/2006
Last updated
02/21/2008
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