| NPI | 1083803795 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARTHOLOMEW J BONAZINGA Physician/Owner 802-775-0100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: VT 0420006395) |
| Enumeration Date | 2007-10-18 |
| Last Update Date | 2010-10-21 |