Provider Demographics
NPI:1144667197
Name:REBEOR, SETH JEREMIAH (ATC)
Entity type:Individual
Prefix:MR
First Name:SETH
Middle Name:JEREMIAH
Last Name:REBEOR
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:789 PINE ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-4933
Mailing Address - Country:US
Mailing Address - Phone:802-264-1052
Mailing Address - Fax:802-264-1053
Practice Address - Street 1:414 ROUTE 7 S
Practice Address - Street 2:UNIT 102
Practice Address - City:MILTON
Practice Address - State:VT
Practice Address - Zip Code:05468-3807
Practice Address - Country:US
Practice Address - Phone:802-892-1413
Practice Address - Fax:802-893-2253
Is Sole Proprietor?:No
Enumeration Date:2013-05-31
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VT00960342255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer