Ms Carolyn A Ingraham, PT | |
4923 Us Route 5, Sojourns Community Health Clinic, Westminster, VT 05158 | |
(802) 722-4023 | |
(802) 722-4137 |
Full Name | Ms Carolyn A Ingraham |
---|---|
Gender | Female |
Speciality | Physical Therapist |
Location | 4923 Us Route 5, Westminster, Vermont |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1972513901 | NPI | - | NPPES |
11325860 | Other | CAQH | |
1010414 | Medicaid | VT | |
59856 | Other | VT | BCBS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 0400003171 (Vermont) | Primary |
Provider Name | Sojourns Community Clinic Inc |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1255427001 PECOS PAC ID: 9234035072 Enrollment ID: O20040518001435 |
Mailing Address | Practice Location Address |
---|---|
Ms Carolyn A Ingraham, PT 4923 Us Route 5, Westminster, VT 05158 Ph: (802) 722-4023 | Ms Carolyn A Ingraham, PT 4923 Us Route 5, Sojourns Community Health Clinic, Westminster, VT 05158 Ph: (802) 722-4023 |
Dr. Susanne Booth, ND, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 4923 Us Route 5, Westminster, VT 05158 Phone: 802-722-4023 | |
Angelique Priscilla, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 4923 Us Route 5, Sojourns Community Health Clinic, Westminster, VT 05158 Phone: 802-722-4023 Fax: 802-722-4137 |