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1233 Shelburne Rd Ste 190, South Burlington, VT 05403-7733 | |
(802) 318-0581 | |
(802) 448-5951 |
Full Name | |
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Type | Facility |
Speciality | Clinic/center - Physical Therapy |
Location | 1233 Shelburne Rd Ste 190, South Burlington, Vermont |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1093378168 | NPI | - | NPPES |
040.0066530 | Other | VT | VT LICENCE NUMBER |
Provider Name | Lauren Wedam |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1811208135 PECOS PAC ID: 0547454514 Enrollment ID: I20101103000941 |
Mailing Address | Practice Location Address |
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Po Box 64823, Burlington, VT 05406-4823 Ph: (802) 318-0581 | 1233 Shelburne Rd Ste 190, South Burlington, VT 05403-7733 Ph: (802) 318-0581 |