Provider Demographics
NPI:1215239579
Name:UMPHREY, ERIN S (PT)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:S
Last Name:UMPHREY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 RIVER RD
Mailing Address - Street 2:APT B
Mailing Address - City:HANOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03755-6613
Mailing Address - Country:US
Mailing Address - Phone:917-751-0523
Mailing Address - Fax:
Practice Address - Street 1:DEPT OF VETERANS AFFAIRS MEDICAL CTR
Practice Address - Street 2:215 NORTH MAIN ST
Practice Address - City:WHITE RIVER JUNCTION
Practice Address - State:VT
Practice Address - Zip Code:05009-0001
Practice Address - Country:US
Practice Address - Phone:802-295-9363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-18
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3453225100000X
VT45099225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist