| NPI | 1104318369 |
|---|---|
| Other Name | FABRIKAL SCHUPAN HEALTH CENTER |
| Other Name | FABRI KAL AND SCHUPAN HEALTH CENTER |
| Entity Type | Organization |
| Authorized Contact | JERRY FORD CEO 802-857-0400 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Enumeration Date | 2018-06-04 |
| Last Update Date | 2018-06-16 |