Individual
JOEL A DESAUTELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT ATC
Contact information
Practice address
426 INDUSTRIAL AVE, SUITE 190, WILLISTON, VT 05495-4448
(802) 860-4360
(802) 488-3160
Mailing address
449 NICHOLS RD, FAIRFAX, VT 05454-9614
(802) 849-0202
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
040-0003725
VT
Other
Enumeration date
08/24/2005
Last updated
09/21/2012
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