Jacqueline Mood Bolster, RPT
Individual provider Active NPI Physical Therapist · Burlington, VT
NPI 1023262425 · NPPES record last updated Nov 11, 2008
Key facts
- NPI
- 1023262425
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 040-0002009 (VT)
- Practice address
- 11 Kilburn St
Burlington, VT 05401-8705 - Phone
- (802) 878-8352
- NPI assigned
- Nov 11, 2008
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 040-0002009 | VT | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 040-0002009 | VT | Yes |
Addresses
Primary practice location
11 Kilburn St
Burlington, VT 05401-8705
Mailing address
2 Damon Dr
Essex Junction, VT 05452-2924
Phone (802) 878-8352
Other providers in Burlington, VT
- Chantal Josee Boisvert
- Elizabeth Boland
- Lisa Michele Bolduc-Bissell
- Ariel Boll
- Ralph Morton Bolman III
- Kristen Bolton
- Karyann Sweet Bombardier
- Nathan Patrick Bombardier
- Nicholas Robert Bonenfant
- Catherine Anne Boniface
All providers in Burlington, VT · Physical Therapist in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 11, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.