Legacy, Jennifer

Legacy, Jennifer is an individual health care provider with primary practice located at 31 Middle St , Lyndonville VT 05851. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Legacy, Jennifer can be contacted via phone (802) 626-4224.

Contact Information

Primary practice address
31 Middle St Lyndonville VT 05851
Phone: (802) 626-4224
Fax: (802) 626-5042
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 040-003546 Vermont

Profile Details

NPI number 1942257977
LBN Legal business name Legacy, Jennifer
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date May 27th, 2006
Last updated Jun 2nd, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942257977 NPPES
Vermont Other 65837 BC/BS
Vermont Other 398447 BC/BS
Vermont Other 0003546 BC/BS
Vermont MEDICAID 1011382 BC/BS

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