Provider Demographics
NPI:1053430504
Name:ON TRACK, LLP
Entity type:Organization
Organization Name:ON TRACK, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LOEFFLER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:802-865-2226
Mailing Address - Street 1:1 MAIN ST STE 102A
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-5259
Mailing Address - Country:US
Mailing Address - Phone:802-865-2226
Mailing Address - Fax:802-865-9921
Practice Address - Street 1:1 MAIN ST STE 102A
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-5259
Practice Address - Country:US
Practice Address - Phone:802-865-2226
Practice Address - Fax:802-865-9921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT040-0003419225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1010612Medicaid
VT520270OtherCIGNA
VT58240OtherBLUE CROSS BLUE SHIELD
VT43681OtherMVP
VT1010612Medicaid