IndividualActive
Stephen Blackett, PTA
NPI 1720283328 · Pediatric Skilled Nursing Facility · Rutland, VT
Provider details
- NPI number
- 1720283328
- Entity type
- Individual
- Primary specialty
- Pediatric Skilled Nursing FacilityNursing & Custodial Care Facilities
- Credential
- PTA
- Sex
- Male
- Sole proprietor
- Yes
- License
- 041-0000401 (VT)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
46 Nichols St
Rutland, VT 05701-3275
Phone: (802) 775-2941
Approximate (ZIP-level) locationGet directions
Mailing address
486 Town Farm Rd
Brandon, VT 05733-9098
Registry dates
- Enumerated
- 2007-06-15
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.