| Kathryn Theisen, | |
|
137 S Main St, Waterbury, VT 05676-1579 | |
| (802) 488-1140 | |
| Not Available |
| Full Name | Kathryn Theisen |
|---|---|
| Gender | Female |
| Speciality | Physical Therapist |
| Location | 137 S Main St, Waterbury, Vermont |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316360720 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 040.0134222 (Vermont) | Primary |
| Provider Name | Provencher Physical Therapy, Inc. |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1225358310 PECOS PAC ID: 8729273925 Enrollment ID: O20150501000097 |
| Mailing Address | Practice Location Address |
|---|---|
| Kathryn Theisen, 13 Stowe St Apt 2, Waterbury, VT 05676-1820 Ph: (262) 391-4118 | Kathryn Theisen, 137 S Main St, Waterbury, VT 05676-1579 Ph: (802) 488-1140 |
Lini B. Wing-alberghini, M.S.P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 137 S Main St, Waterbury, VT 05676 Phone: 802-244-1140 | |
Ms. Kathy C Provencher, Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 137s Main St, Waterbury, VT 05676 Phone: 802-244-1140 Fax: 802-244-6851 | |
Natasha Anand, PT,DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 80 S Main St Ste 7, Waterbury, VT 05676 Phone: 802-882-8538 | |
Vasta Pt Waterbury Llc Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 80 S Main St Ste 6, Waterbury, VT 05676 Phone: 802-399-2244 | |
Carolyn Bauman Dessureau, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 137 S Main St, Waterbury, VT 05676 Phone: 802-244-1140 | |
Elayne Kay Geba, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 30 Foundry St Unit B, Waterbury, VT 05676 Phone: 802-560-8757 Fax: 484-848-5190 |