| NPI | 1164605283 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE MARIE CONLEY Owner/Operator 802-253-2726 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VT 0420009406) |
| Enumeration Date | 2007-12-12 |
| Last Update Date | 2007-12-12 |