Provider Demographics
NPI:1518552942
Name:ALDEN, LINCOLN
Entity type:Individual
Prefix:
First Name:LINCOLN
Middle Name:
Last Name:ALDEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78 VT RTE 132
Mailing Address - Street 2:
Mailing Address - City:SOUTH STRAFFORD
Mailing Address - State:VT
Mailing Address - Zip Code:05070-7728
Mailing Address - Country:US
Mailing Address - Phone:802-356-2757
Mailing Address - Fax:
Practice Address - Street 1:78 VT RTE 132
Practice Address - Street 2:
Practice Address - City:SOUTH STRAFFORD
Practice Address - State:VT
Practice Address - Zip Code:05070-7728
Practice Address - Country:US
Practice Address - Phone:802-356-2757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-08
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1287225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant