Individual
MICHELLE DUSSAULT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
262 WESTERN AVE, - BACK APT, BRATTLEBORO, VT 05301-6246
(813) 787-9668
Mailing address
262 WESTERN AVE, - BACK APT, BRATTLEBORO, VT 05301-6246
(813) 787-9668
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
041.0095968
VT
225200000X
Physical Therapy Assistant
9154
MA
Other
Enumeration date
12/04/2015
Last updated
12/04/2015
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