Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 041-0000428 | VT |
NPI | 1013179910 |
---|---|
Provider Name | Mr. Robert Phillip Giguere SR. |
First Address | Barnard, VT 05031-0084 |
Second Address | Barnard, VT 05031-0084 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2008 |
Last Update Date | 01/07/2008 |