Individual
MR. JEFFREY JOSEPH VIDETTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
328 DEWEY ST, BENNINGTON, VT 05201-2225
(802) 447-2101
(802) 447-1902
Mailing address
328 DEWEY ST, BENNINGTON, VT 05201-2225
(802) 447-2101
(802) 447-1902
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0000818
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2775
BCBS OF VT
VT
01
—
43169
MOHAWK VALLEY PLAN
VT
Enumeration date
11/18/2005
Last updated
10/24/2011
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