| NPI | 1225400237 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL GARDNER CEO 802-855-2083 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 152W00000X Optometrist |
| 207Q00000X Family Medicine | |
| 207W00000X Ophthalmology | |
| Enumeration Date | 2015-10-29 |
| Last Update Date | 2025-02-17 |