Individual
JANE LILLIAN OLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
10606 RT. 106 SOUTH, WOODSTOCK, VT 05091
(802) 457-4213
Mailing address
3 EATON PL, WOODSTOCK, VT 05091-1008
(802) 457-2153
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0400002372
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
48246
BLUE CROSS BLUE SHIELD
VT
05
—
OVN2054
—
VT
Enumeration date
06/22/2006
Last updated
07/08/2007
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