Provider Demographics
NPI:1053692954
Name:VOLK, CHAD C (DPT)
Entity type:Individual
Prefix:
First Name:CHAD
Middle Name:C
Last Name:VOLK
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:167 MONKTON RD # 101B
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:VT
Mailing Address - Zip Code:05443-5045
Mailing Address - Country:US
Mailing Address - Phone:802-453-7200
Mailing Address - Fax:802-329-2302
Practice Address - Street 1:167 MONKTON RD # 101B
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:VT
Practice Address - Zip Code:05443-5045
Practice Address - Country:US
Practice Address - Phone:802-453-7200
Practice Address - Fax:802-329-2302
Is Sole Proprietor?:No
Enumeration Date:2011-09-06
Last Update Date:2022-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
VT040.0077340208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist