Basic Information
| Provider Information | |||||||||
| NPI: | 1770746877 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VO | ||||||||
| FirstName: | ANN | ||||||||
| MiddleName: | PHUONG | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 67 LECLAIR ST | ||||||||
| Address2: | |||||||||
| City: | WINOOSKI | ||||||||
| State: | VT | ||||||||
| PostalCode: | 054041850 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4084641562 | ||||||||
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| Practice Location | |||||||||
| Address1: | 111 COLCHESTER AVE | ||||||||
| Address2: | GRADUATE MEDICAL EDUCATION, WEST PAVILION LEVEL 2 | ||||||||
| City: | BURLINGTON | ||||||||
| State: | VT | ||||||||
| PostalCode: | 054011473 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8028472700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/08/2008 | ||||||||
| LastUpdateDate: | 04/04/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 6752 | CA | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.