Maghan Charland, ATC

Individual provider Active NPI Athletic Trainer · Williston, VT

NPI 1578834065 · NPPES record last updated Jan 16, 2012

Key facts

NPI
1578834065
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
104-0081326 (VT)
Practice address
426 Industrial Ave
Suite 190
Williston, VT 05495-4448
Phone
(802) 860-4360
Fax
(802) 488-3160
NPI assigned
Jan 16, 2012
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
104-0081326VTMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
PT 360 Inc Athletic Trainer Past
since Nov 22, 2010
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 104-0081326 VT Yes

Addresses

Primary practice location

426 Industrial Ave
Suite 190
Williston, VT 05495-4448

Mailing address

426 Industrial Ave
Suite 190
Williston, VT 05495-4448
Phone (802) 860-4360

Other providers in Williston, VT

All providers in Williston, VT · Athletic Trainer in Vermont

Sources for this page

Verify at the official NPI Registry.