Individual
CHARLES ANTHONY CARBONAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
80 COLCHESTER AVE, BURLINGTON, VT 05401-1417
(802) 657-7779
Mailing address
426 INDUSTRIAL AVE STE 190, WILLISTON, VT 05495-7904
(610) 203-9136
(802) 876-7095
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
040-0134096
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040-0134096
STATE OF VERMONT LICENSE
VT
05
—
6702786
—
VT
Enumeration date
08/21/2019
Last updated
06/10/2020
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