Provider Demographics
NPI:1871885913
Name:BACK ON TRACK PHYSICAL THERAPY PLLC
Entity type:Organization
Organization Name:BACK ON TRACK PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDSEY
Authorized Official - Middle Name:J
Authorized Official - Last Name:SAVAGE
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:802-855-8068
Mailing Address - Street 1:365 US ROUTE 4 E
Mailing Address - Street 2:
Mailing Address - City:RUTLAND
Mailing Address - State:VT
Mailing Address - Zip Code:05701-9035
Mailing Address - Country:US
Mailing Address - Phone:802-855-8068
Mailing Address - Fax:802-855-8436
Practice Address - Street 1:365 US ROUTE 4 E
Practice Address - Street 2:
Practice Address - City:RUTLAND
Practice Address - State:VT
Practice Address - Zip Code:05701-9035
Practice Address - Country:US
Practice Address - Phone:802-855-8068
Practice Address - Fax:802-855-8436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-09
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1010821Medicaid
VTFAVN3525Medicare UPIN