Organization
VERMONT SPORTS MEDICINE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAUREEN COREY GIBEAULT (DIRECTOR)
(802) 775-1300
Entity
Organization
Contact information
Practice address
5 ALBERT CREE DR, RUTLAND, VT 05701
(802) 775-1300
(802) 773-9300
Mailing address
5 ALBERT CREE DR, RUTLAND, VT 05701
(802) 775-1300
(802) 773-9300
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4471
BLUE CROSS OF VT
—
01
—
50922
MVP
—
01
—
9690007
CIGNA
—
05
—
OVN2225
—
VT
Enumeration date
07/27/2006
Last updated
09/11/2025
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