Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251S0007X | Physical Therapist - Sports | 104.0078877 | VT |
NPI | 1427339712 |
---|---|
Provider Name | Holly L Politis |
First Address | Center Rutland, VT 05736-9701 |
Second Address | Center Rutland, VT 05736-9701 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2011 |
Last Update Date | 31/08/2011 |