| NPI | 1114086808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY J WARGO President 802-496-2202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: VT 042-0007289) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2008-04-01 |