| The Lifestyle Athlete Plc | |
|
520 Avenue D, Williston, VT 05495-7136 | |
| (802) 388-2318 | |
| (802) 399-2505 |
| Full Name | The Lifestyle Athlete Plc |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 520 Avenue D, Williston, Vermont |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437778008 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | (* (Not Available)) | Primary |
| Provider Name | Casey Baczewski |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1619420080 PECOS PAC ID: 4789970716 Enrollment ID: I20160831000545 |
| Provider Name | Crystal Marie Bryce |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1427641489 PECOS PAC ID: 0648686543 Enrollment ID: I20210301001282 |
| Mailing Address | Practice Location Address |
|---|---|
| The Lifestyle Athlete Plc Po Box 8381, Essex, VT 05451-8381 Ph: (802) 338-1406 | The Lifestyle Athlete Plc 520 Avenue D, Williston, VT 05495-7136 Ph: (802) 388-2318 |
Wellfound Physical Therapy And Fitness, Llc Physical Therapist Medicare: Medicare Enrolled Practice Location: 1193 S Brownell Rd Ste 20, Williston, VT 05495 Phone: 802-343-6279 | |
Maria C Nolan, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 205 Cornerstone Dr, Williston, VT 05495 Phone: 802-878-8330 Fax: 802-878-8344 | |
Paula Larose, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 30 Hawthorne St, Williston, VT 05495 Phone: 802-876-6000 | |
Zafir George Bludevich, PHYSICAL THERAPIST Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 115 Wellness Dr, Williston, VT 05495 Phone: 802-860-1358 | |
Benjamin M Corcoran, M.S.,P.T. Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 115 Wellness Dr, Williston, VT 05495 Phone: 802-860-1358 Fax: 802-860-1093 | |
Lillian Devereux, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 289 Hurricane Ln Ste 102, Williston, VT 05495 Phone: 802-655-7575 | |
Maryclaire Mcgovern, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 62 Merchants Row Ste 202, Williston, VT 05495 Phone: 802-857-5407 |