Provider Demographics
NPI:1538203765
Name:RODENRYS, ANNE (PT)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:RODENRYS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 45
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLE
Mailing Address - State:VT
Mailing Address - Zip Code:05458-0045
Mailing Address - Country:US
Mailing Address - Phone:802-373-9146
Mailing Address - Fax:802-372-3858
Practice Address - Street 1:82 ADAMS SCHOOL RD
Practice Address - Street 2:
Practice Address - City:GRAND ISLE
Practice Address - State:VT
Practice Address - Zip Code:05458-2109
Practice Address - Country:US
Practice Address - Phone:802-373-9146
Practice Address - Fax:802-372-3858
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist