Provider Demographics
NPI:1750581831
Name:MAUNTLER, ELIZABETH N (PT)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:N
Last Name:MAUNTLER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:N
Other - Last Name:FRECHETTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:3285 RIVER ROAD
Mailing Address - Street 2:
Mailing Address - City:DUXBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05676
Mailing Address - Country:US
Mailing Address - Phone:802-310-6707
Mailing Address - Fax:802-310-6707
Practice Address - Street 1:244 GRANGER RD
Practice Address - Street 2:
Practice Address - City:BARRE
Practice Address - State:VT
Practice Address - Zip Code:05641-5367
Practice Address - Country:US
Practice Address - Phone:802-225-3942
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT040-0003508225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist