Individual
MICHAEL JOHN MAINOLFI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
5 ALBERT CREE DR, RUTLAND, VT 05701
(802) 775-1300
(802) 773-9300
Mailing address
5 ALBERT CREE DR, RUTLAND, VT 05701
(802) 775-1300
(802) 773-9300
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0400002520
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00028306
BLUE CROSS BLUE SHIELD VT
—
01
—
43430
MVP
—
01
—
7026628
AETNA
—
05
—
OVN2146
—
VT
Enumeration date
08/11/2006
Last updated
01/02/2009
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