Individual
DR. LAUREN M WEDAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1233 SHELBURNE RD STE 470, SOUTH BURLINGTON, VT 05403-7780
(802) 318-0581
(508) 448-5951
Mailing address
PO BOX 64823, BURLINGTON, VT 05406-4823
(802) 318-0581
(802) 448-5951
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
040.0066530
VT
2251G0304X
Geriatric Physical Therapist
040.0066530
VT
2251G0304X
Geriatric Physical Therapist
Primary
20155
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040.0066530
LICENSURE NUMBER
VT
Enumeration date
07/01/2010
Last updated
07/29/2019
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