Organization
DOUG MCCORKLE PT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS R MCCORKLE PT (OWNER)
(802) 387-3025
Entity
Organization
Contact information
Practice address
247 CANOE BROOK RD, E DUMMERSTON, VT 05346-9770
(802) 387-3025
(802) 387-3025
Mailing address
247 CANOE BROOK RD, E DUMMERSTON, VT 05346-9770
(802) 387-3025
(802) 387-3025
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
040-0003309
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0VN2522
—
VT
01
—
11325931
CAQH
VT
01
—
49955
BCBS
VT
Enumeration date
02/11/2010
Last updated
02/11/2010
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