Individual
MICHELLE OBRIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
151 BLAIR PARK RD, WILLISTON, VT 05495-7435
(802) 879-0909
Mailing address
6 MARKET PL, SUITE 1, ESSEX JUNCTION, VT 05452-2933
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
040-0003201
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
065-38619
BCBS
VT
05
—
1007657
—
VT
01
—
43V210
MVP
VT
Enumeration date
01/18/2007
Last updated
07/08/2007
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