Individual
RONNA MARIE DAVINE
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
0400002469
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00004675
BLUE CROSS BLUE SHIELD OF
VT
01
—
988038
MVP
—
05
—
OVN2144
—
VT
Enumeration date
02/27/2007
Last updated
07/08/2007
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