NPI | 1063715886 |
---|---|
Doing Business As | COMMON STREET HEALTH CENTER |
Entity Type | Organization |
Authorized Contact | GRANT L WHITMER Executive Director 802-468-5641 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 207Q00000X Family Medicine |
Enumeration Date | 2010-12-16 |
Last Update Date | 2011-08-10 |