| NPI | 1003861782 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JON W ASSELIN COO 802-872-4326 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2023-06-29 |