| NPI | 1003117078 |
|---|---|
| Doing Business As | GREEN MOUNTAIN FAMILY MEDICINE |
| Entity Type | Organization |
| Authorized Contact | MARK E LOGAN Owner 802-775-7798 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: VT 042-0006819) |
| Enumeration Date | 2010-11-08 |
| Last Update Date | 2015-01-12 |