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Organization

GREEN MOUNTAIN REHABILITATION & SPORTS MEDICINE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ERIC ELSINGER MSPT (MEMBER)
(802) 861-6700
Entity
Organization

Contact information

Practice address
90 MAIN ST, BURLINGTON, VT 05401-8419
(802) 861-6700
(802) 861-2143
Mailing address
90 MAIN ST, BURLINGTON, VT 05401-8419
(802) 861-6700
(802) 861-2143

Taxonomy

Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
040-0003248
VT
2251X0800X
Orthopedic Physical Therapist
040-0003401
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00048616
BCBS
VT
01
00049991
BCBS
VT
05
1007705
VT
05
1009289
VT
01
1386659100
NPI
VT
01
1992711923
NPI
VT
01
4149377
MVP
VT
01
48616
TVHP
VT
01
5268301
FAP
VT
01
5273607
FAP
VT
01
6000628
MVP
VT
01
6245674
CIGNA
VT
01
69511
TVHP
VT
01
9554226
CIGNA
VT
Enumeration date
03/08/2007
Last updated
11/08/2012
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